دورية أكاديمية
أعرض في EDS

Metformin Use Is Associated With Longer Progression-Free Survival of Patients With Diabetes and Pancreatic Neuroendocrine Tumors Receiving Everolimus and/or Somatostatin Analogues.

التفاصيل البيبلوغرافية
العنوان: Metformin Use Is Associated With Longer Progression-Free Survival of Patients With Diabetes and Pancreatic Neuroendocrine Tumors Receiving Everolimus and/or Somatostatin Analogues.
المؤلفون: Pusceddu S; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy. Electronic address: sara.pusceddu@istitutotumori.mi.it., Vernieri C; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Fondazione Istituto FIRC di Oncologia Molecolare (IFOM), Milan, Italy., Di Maio M; Dipartimento di Oncologia, Università degli Studi di Torino, A. O. Ordine Mauriziano, Turin, Italy., Marconcini R; Dipartimento di Oncologia, Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy., Spada F; IEO - Istituto Europeo di Oncologia, ENETS Center of Excellence, Milan, Italy., Massironi S; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy., Ibrahim T; Centro di Osteoncologia e Tumori Rari, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy., Brizzi MP; Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy., Campana D; Policlinico Sant'Orsola Malpighi, Bologna, Italy., Faggiano A; Unità di chirurgia tiroidea e paratiroidea, Istituto Nazionale per lo studio e la cura dei tumori 'Fondazione G. Pascale' - IRCCS, Naples, Italy., Giuffrida D; IOM- Istituto Oncologico del Mediterraneo, Catania, Italy., Rinzivillo M; Azienda Ospedaliera Universitaria Sant'Andrea, ENETS Center of Excellence, Rome, Italy., Cingarlini S; Azienda Ospedaliera Universitaria, Verona, Italy., Aroldi F; Fondazione Poliambulanza, Brescia, Italy., Antonuzzo L; A. O. U. Careggi, Firenze, Italy., Berardi R; Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy., Catena L; Policlinico di Monza, Monza, Italy., De Divitiis C; IRCCS Fondazione Pascale, ENETS Center of Excellence, Naples, Italy., Ermacora P; Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy., Perfetti V; Fondazione IRCCS Policlinico San Matteo, SC oncologia, Pavia, Italy., Fontana A; Policlinico di Modena, Italy., Razzore P; Unit of Endocrinology, Ospedale Mauriziano, Torino, Italy., Carnaghi C; Istituto Clinico Humanitas, Rozzano, ENETS Center of Excellence, Italy., Davì MV; Ospedale Policlinico Borgo Roma, Verona, Italy., Cauchi C; Ospedale S Croce e Carle, Cuneo, Italy., Duro M; Ospedale Valduce Como, Italy., Ricci S; Dipartimento di Oncologia, Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy., Fazio N; IEO - Istituto Europeo di Oncologia, ENETS Center of Excellence, Milan, Italy., Cavalcoli F; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy., Bongiovanni A; Centro di Osteoncologia e Tumori Rari, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy., La Salvia A; Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano, Italy., Brighi N; Policlinico Sant'Orsola Malpighi, Bologna, Italy., Colao A; Endocrinology Section, Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Italy., Puliafito I; IOM- Istituto Oncologico del Mediterraneo, Catania, Italy., Panzuto F; Azienda Ospedaliera Universitaria Sant'Andrea, ENETS Center of Excellence, Rome, Italy., Ortolani S; Azienda Ospedaliera Universitaria, Verona, Italy., Zaniboni A; Fondazione Poliambulanza, Brescia, Italy., Di Costanzo F; A. O. U. Careggi, Firenze, Italy., Torniai M; Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy., Bajetta E; Policlinico di Monza, Monza, Italy., Tafuto S; IRCCS Fondazione Pascale, ENETS Center of Excellence, Naples, Italy., Garattini SK; Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy., Femia D; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy., Prinzi N; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy., Concas L; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy., Lo Russo G; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Medical-Surgical Science and Traslational Medicine Departement, Sapienza University, Rome, Italy., Milione M; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy., Giacomelli L; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy., Buzzoni R; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy., Delle Fave G; Azienda Ospedaliera Universitaria Sant'Andrea, ENETS Center of Excellence, Rome, Italy., Mazzaferro V; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Universita' degli Studi di Milano, Milan, Italy., de Braud F; Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, ENETS Center of Excellence, Milan, Italy; Universita' degli Studi di Milano, Milan, Italy.
المصدر: Gastroenterology [Gastroenterology] 2018 Aug; Vol. 155 (2), pp. 479-489.e7. Date of Electronic Publication: 2018 Apr 13.
نوع المنشور: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 0374630 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-0012 (Electronic) Linking ISSN: 00165085 NLM ISO Abbreviation: Gastroenterology Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : W.B. Saunders
Original Publication: Baltimore.
مواضيع طبية MeSH: Antineoplastic Agents/*therapeutic use , Diabetes Mellitus, Type 2/*drug therapy , Everolimus/*therapeutic use , Metformin/*therapeutic use , Neuroendocrine Tumors/*drug therapy , Pancreatic Neoplasms/*drug therapy , Somatostatin/*analogs & derivatives, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Diabetes Mellitus, Type 2/mortality ; Disease-Free Survival ; Female ; Humans ; Hypoglycemic Agents/therapeutic use ; Italy/epidemiology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neuroendocrine Tumors/mortality ; Neuroendocrine Tumors/pathology ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Young Adult
مستخلص: Background & Aims: Metformin seems to have anticancer effects. However, it is not clear whether use of glycemia and metformin affect outcomes of patients with advanced pancreatic neuroendocrine tumors (pNETs). We investigated the association between glycemia and progression-free survival (PFS) of patients with pNETs treated with everolimus and/or somatostatin analogues, as well as the association between metformin use and PFS time.
Methods: We performed a retrospective analysis of 445 patients with advanced pNET treated at 24 medical centers in Italy from 1999 through 2015. Data on levels of glycemia were collected at time of diagnosis of pNET, before treatment initiation, and during treatment with everolimus (with or without somatostatin analogues), octreotide, or lanreotide. Diabetes was defined as prior or current use of glycemia control medication and/or fasting plasma glucose level ≥ 126 mg/dL, hemoglobin A1c ≥ 6.5% (48 mmol/L), or a random sample of plasma glucose ≥ 200 mg/dL (11.1 mmol/L), with reported classic symptoms of hyperglycemia or hyperglycemic crisis. Patients were assigned to groups based on diagnosis of diabetes before or during antitumor therapy. PFS was compared between patients with vs without diabetes. Among patients with diabetes, the association between metformin use and PFS was assessed. We performed sensitivity and landmark analyses to exclude patients who developed diabetes while receiving cancer treatment and to exclude a potential immortal time bias related to metformin intake.
Results: PFS was significantly longer in patients with diabetes (median, 32.0 months) than without diabetes (median, 15.1 months) (hazard ratio for patients with vs without diabetes, 0.63; 95% confidence interval, 0.50-0.80; P = .0002). PFS of patients treated with metformin was significantly longer (median PFS, 44.2 months) than for patients without diabetes (hazard ratio for survival of patients with diabetes receiving metformin vs without diabetes, 0.45; 95% confidence interval, 0.32-0.62; P < .00001) and longer than for patients with diabetes receiving other treatments (median PFS, 20.8 months; hazard ratio, 0.49; 95% confidence interval, 0.34-0.69; P < .0001). In multivariable analysis, adjusted for other factors associated with outcomes, metformin was associated with longer PFS but level of glycemia was not. Metformin was associated with increased PFS of patients receiving somatostatin analogues and in those receiving everolimus, with or without somatostatin analogues. Sensitivity and landmark analyses produced similar results.
Conclusions: In a retrospective study of patients with pNETs, we found a significant association between metformin use and longer PFS.
(Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Chemoprevention; Drug; Insulin Resistance; Pancreas
المشرفين على المادة: 0 (Antineoplastic Agents)
0 (Hypoglycemic Agents)
51110-01-1 (Somatostatin)
9100L32L2N (Metformin)
9HW64Q8G6G (Everolimus)
تواريخ الأحداث: Date Created: 20180416 Date Completed: 20180813 Latest Revision: 20180813
رمز التحديث: 20240628
DOI: 10.1053/j.gastro.2018.04.010
PMID: 29655834
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-0012
DOI:10.1053/j.gastro.2018.04.010