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http://dx.doi.org/10.7314/APJCP.2015.16.15.6621

Metformin Addition to Chemotherapy in Stage IV Non-Small Cell Lung Cancer: an Open Label Randomized Controlled Study  

Sayed, Rana (Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University)
Saad, Amr S (Department of Clinical Oncology, Faculty of Medicine, Ain Shams University)
El Wakeel, Lamia (Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University)
Elkholy, Engi (Department of Clinical Oncology, Faculty of Medicine, Ain Shams University)
Badary, Osama (Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.16, no.15, 2015 , pp. 6621-6626 More about this Journal
Abstract
Purpose: To evaluate effects of metformin on clinical outcome of non-diabetic patients with stage IV NSCLC. Materials and Methods: A prospective, randomized, open-label, controlled pilot study was conducted on patients with stage IV NSCLC with an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-2, excluding patients with diabetes and lactic acidosis. Thirty chemo-$na\ddot{i}ve$, non-diabetic patients with stage IV NSCLC were enrolled. Fifteen patients received intravenous gemcitabine/cisplatin regimen alone (arm B) while fifteen patients received the same regimen plus daily oral metformin 500mg (arm A). The effect of metformin on chemotherapy-response rates, survival, and adverse events in these patients was evaluated. Results: Objective response rate (ORR) and median overall survival (OS) in arms A and B were 46.7% versus 13.3% respectively, p=0.109 and 12 months versus 6.5 months, respectively, p=0.119. Median progression free survival (PFS) in arms A and B was 5.5 months versus 5 months, p=0.062. No significant increase in toxicity was observed in arm A versus arm B. Percentage of patients who experienced nausea was significantly lower in arm A versus arm B, at 26.7% versus 66.7% respectively, p=0.028. Conclusions: Metformin administration reduced occurrence of chemotherapy induced-nausea. Non-statistically significant improvements in the ORR or OS were observed. Metformin had no effect on PFS.
Keywords
Metformin; lung cancer; survival; mTOR; non-small cell;
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