Metformin use and survival after non‐small cell lung cancer: A cohort study in the US Military health system. Issue 2 (4th May 2017)

• Record Type: Journal Article
• Authors: Lin, Jie; Gill, Abegail; Zahm, Shelia H.; Carter, Corey A.; Shriver, Craig D.; Nations, Joel A.; Anderson, William F.; McGlynn, Katherine A.; Zhu, Kangmin
• Is Part Of: International journal of cancer. Volume 141:Issue 2(2017:Jul. 15)
• Page Start: 254
• Page End: 263
• Publication Date: 2017-05-04
• Subjects: metformin -- survival -- non‐small cell lung cancer -- type II diabetes; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.30724
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Research suggests that metformin may be associated with improved survival in cancer patients with type II diabetes. This study assessed whether metformin use after non‐small cell lung cancer (NSCLC) diagnosis is associated with overall survival among type II diabetic patients with NSCLC in the U.S. military health system (MHS). The study included 636 diabetic patients with histologically confirmed NSCLC diagnosed between 2002 and 2007, identified from the linked database from the Department of Defense's Central Cancer Registry (CCR) and the Military Health System Data Repository (MDR). Time‐dependent multivariate Cox proportional hazards models were used to assess the association between metformin use and overall survival during follow‐up. Among the 636 patients, 411 died during the follow‐up. The median follow‐up time was 14.6 months. Increased post‐diagnosis cumulative use (per 1 year of use) conferred a significant reduction in mortality (adjusted hazard ratio (HR) = 0.76; 95% CI = 0.65–0.88). Further analysis by duration of use revealed that compared to non‐users, the lowest risk reduction occurred among patients with the longest duration of use ( i.e . use for more than 2 years) (HR = 0.19; 95% CI = 0.09–0.40). Finally, the reduced mortality was particularly observed only among patients who also used metformin before lung cancer diagnosis and among patients at early stage of diagnosis. Prolonged duration of metformin use in the study population was associated with improved survival, especially among early stage patients. Future research with a larger number of patients is warranted. Abstract : What's new? Because diabetes is common, many cancer patients face a dual challenge of managing their blood sugar while fighting cancer. Metformin is a medication commonly prescribed to treat diabetes, and also has anticancer properties. These authors investigated whether metformin improves survival among non‐small cell lung cancer patients, using data from the US Military Health System. Patients taking metformin survived longer than those not using the drug, they found, particularly those who were already taking metformin before their cancer diagnosis. The longer a person had been taking metformin, the more their risk was reduced.