Metformin use is associated with better survival of diabetic patients with pancreatic cancer

Navid Sadeghi, James L. Abbruzzese, Sai Ching J Yeung, Manal Hassan, Donghui Li

Research output: Contribution to journalArticle

190 Citations (Scopus)

Abstract

Purpose: Accumulating evidence suggests that metformin has antitumor activity. The aim of this study was to determine whether metformin use has a survival benefit in patients with pancreatic cancer. Experimental Design: We conducted a retrospective study of patients with diabetes and pancreatic cancer treated at The University of Texas MD Anderson Cancer Center (Houston, TX). Information on diabetes history, including treatment modalities and clinical outcome of pancreatic cancer, was collected using personal interviews and medical record review. Survival analysis was carried out using a Kaplan-Meier plot, log-rank test, and Cox proportional hazards regression models. Results:Amongthe 302 patients identified, there were no significant differences in demographic or major clinical characteristics between the patients who had received metformin (n = 117) and those who had not (n = 185). The 2-year survival rate was 30.1% for the metformin group and 15.4% for the non-metformin group (P = 0.004; χ 2 test). The median overall survival time was 15.2 months for the metformin group, and 11.1 months for the non-metformin group (P=0.004, log-rank test). Metformin users had a 32% lower risk of death; the HR (95% confidence interval) was 0.68 (0.52-0.89) in a univariate model (P = 0.004), 0.64 (0.48-0.86) after adjusting for other clinical predictors (P = 0.003), and 0.62 (0.44-0.87) after excluding insulin users (P = 0.006). Metformin use was significantly associated with longer survival in patients with nonmetastatic disease only. Conclusions: Our finding that metformin use was associated with improved outcome of patients with diabetes and pancreatic cancer should be confirmed in independent studies. Future research should prospectively evaluate metformin as a supplemental therapy in this population.

Original languageEnglish (US)
Pages (from-to)2905-2912
Number of pages8
JournalClinical Cancer Research
Volume18
Issue number10
DOIs
StatePublished - May 15 2012

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Metformin
Pancreatic Neoplasms
Survival
Personal Health Records
Survival Analysis
Proportional Hazards Models
Research Design
Survival Rate
Retrospective Studies
History
Demography
Confidence Intervals
Interviews
Insulin
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Metformin use is associated with better survival of diabetic patients with pancreatic cancer. / Sadeghi, Navid; Abbruzzese, James L.; Yeung, Sai Ching J; Hassan, Manal; Li, Donghui.

In: Clinical Cancer Research, Vol. 18, No. 10, 15.05.2012, p. 2905-2912.

Research output: Contribution to journalArticle

Sadeghi, Navid ; Abbruzzese, James L. ; Yeung, Sai Ching J ; Hassan, Manal ; Li, Donghui. / Metformin use is associated with better survival of diabetic patients with pancreatic cancer. In: Clinical Cancer Research. 2012 ; Vol. 18, No. 10. pp. 2905-2912.
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abstract = "Purpose: Accumulating evidence suggests that metformin has antitumor activity. The aim of this study was to determine whether metformin use has a survival benefit in patients with pancreatic cancer. Experimental Design: We conducted a retrospective study of patients with diabetes and pancreatic cancer treated at The University of Texas MD Anderson Cancer Center (Houston, TX). Information on diabetes history, including treatment modalities and clinical outcome of pancreatic cancer, was collected using personal interviews and medical record review. Survival analysis was carried out using a Kaplan-Meier plot, log-rank test, and Cox proportional hazards regression models. Results:Amongthe 302 patients identified, there were no significant differences in demographic or major clinical characteristics between the patients who had received metformin (n = 117) and those who had not (n = 185). The 2-year survival rate was 30.1{\%} for the metformin group and 15.4{\%} for the non-metformin group (P = 0.004; χ 2 test). The median overall survival time was 15.2 months for the metformin group, and 11.1 months for the non-metformin group (P=0.004, log-rank test). Metformin users had a 32{\%} lower risk of death; the HR (95{\%} confidence interval) was 0.68 (0.52-0.89) in a univariate model (P = 0.004), 0.64 (0.48-0.86) after adjusting for other clinical predictors (P = 0.003), and 0.62 (0.44-0.87) after excluding insulin users (P = 0.006). Metformin use was significantly associated with longer survival in patients with nonmetastatic disease only. Conclusions: Our finding that metformin use was associated with improved outcome of patients with diabetes and pancreatic cancer should be confirmed in independent studies. Future research should prospectively evaluate metformin as a supplemental therapy in this population.",
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