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Continuous use of metformin can improve survival in type 2 diabetic patients with ovarian cancer: A retrospective study.

Abstract Evidence indicates that type 2 diabetes may stimulate the initiation and progression of several types of cancer. Metformin, a drug most commonly used to treat type 2 diabetes, may inhibit cancer cell growth and reduce the risk of cancer. However, evidence of the antitumor effects of metformin on ovarian cancer is still limited.In this study, we retrospectively examined the effects of metformin on ovarian cancer patients with diabetes at our institution.We identified 568 consecutive patients who were newly diagnosed with ovarian cancer and treated between January 2011 and March 2014. Patients with International Federation of Gynecology and Obstetrics (FIGO) stage I to IV epithelial ovarian, fallopian, or peritoneal cancer were included. Patients with type 1 diabetes, incomplete records (including medication records) and any other cancer before their ovarian cancer diagnosis, as well as those diagnosed with diabetes more than 6 months after their ovarian cancer diagnosis, were excluded. Out of 568 patients, 48 (8.5%) patients with type 2 diabetes continuously used metformin, 34 (5.9%) patients with type 2 diabetes did not take metformin, 22 (3.9%) patients with type 2 diabetes discontinued metformin, and 464 (81.7%) ovarian cancer patients were nondiabetic controls. Longer progression-free survival (PFS) and overall survival (OS) were observed in ovarian cancer patients with diabetes who were taking metformin than in diabetic patients not taking metformin, diabetic patients who discontinued metformin, and nondiabetic ovarian cancer patients (P = .001). After adjusting for possible confounders, metformin use was associated with a lower risk for disease relapse [hazard ratio (HR) = 0.34; 95% confidence interval (CI): 0.27-0.67; P < .01] and disease-related death (HR = 0.29; 95% CI: 0.13-0.58, P = .03) among ovarian cancer patients with diabetes.Metformin use may decrease the risk for disease recurrence and death in patients with ovarian cancer, but the drug treatment must be continuous.
PMID
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Relationship of type II diabetes and metformin use to ovarian cancer progression, survival, and chemosensitivity.

Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28723808
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170808
LR  - 20170808
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Continuous use of metformin can improve survival in type 2 diabetic patients with
      ovarian cancer: A retrospective study.
PG  - e7605
LID - 10.1097/MD.0000000000007605 [doi]
AB  - Evidence indicates that type 2 diabetes may stimulate the initiation and
      progression of several types of cancer. Metformin, a drug most commonly used to
      treat type 2 diabetes, may inhibit cancer cell growth and reduce the risk of
      cancer. However, evidence of the antitumor effects of metformin on ovarian cancer
      is still limited.In this study, we retrospectively examined the effects of
      metformin on ovarian cancer patients with diabetes at our institution.We
      identified 568 consecutive patients who were newly diagnosed with ovarian cancer 
      and treated between January 2011 and March 2014. Patients with International
      Federation of Gynecology and Obstetrics (FIGO) stage I to IV epithelial ovarian, 
      fallopian, or peritoneal cancer were included. Patients with type 1 diabetes,
      incomplete records (including medication records) and any other cancer before
      their ovarian cancer diagnosis, as well as those diagnosed with diabetes more
      than 6 months after their ovarian cancer diagnosis, were excluded. Out of 568
      patients, 48 (8.5%) patients with type 2 diabetes continuously used metformin, 34
      (5.9%) patients with type 2 diabetes did not take metformin, 22 (3.9%) patients
      with type 2 diabetes discontinued metformin, and 464 (81.7%) ovarian cancer
      patients were nondiabetic controls. Longer progression-free survival (PFS) and
      overall survival (OS) were observed in ovarian cancer patients with diabetes who 
      were taking metformin than in diabetic patients not taking metformin, diabetic
      patients who discontinued metformin, and nondiabetic ovarian cancer patients (P =
      .001). After adjusting for possible confounders, metformin use was associated
      with a lower risk for disease relapse [hazard ratio (HR) = 0.34; 95% confidence
      interval (CI): 0.27-0.67; P &lt; .01] and disease-related death (HR = 0.29; 95% CI: 
      0.13-0.58, P = .03) among ovarian cancer patients with diabetes.Metformin use may
      decrease the risk for disease recurrence and death in patients with ovarian
      cancer, but the drug treatment must be continuous.
FAU - Wang, Shan-Bing
AU  - Wang SB
AD  - aDepartment of Oncology bLaboratory Medicine, the Second People's Hospital of
      Yibin City, Yibin, Sichuan, China.
FAU - Lei, Kai-Jian
AU  - Lei KJ
FAU - Liu, Jia-Pei
AU  - Liu JP
FAU - Jia, Yu-Ming
AU  - Jia YM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Hypoglycemic Agents)
RN  - 9100L32L2N (Metformin)
SB  - AIM
SB  - IM
MH  - Antineoplastic Agents/therapeutic use
MH  - Diabetes Mellitus, Type 2/*complications/*drug therapy
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Metformin/*therapeutic use
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Ovarian Neoplasms/*complications/drug therapy
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC5521948
EDAT- 2017/07/21 06:00
MHDA- 2017/08/09 06:00
CRDT- 2017/07/21 06:00
AID - 10.1097/MD.0000000000007605 [doi]
AID - 00005792-201707210-00073 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7605. doi: 10.1097/MD.0000000000007605.