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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: Marilina Duro, Sara Pusceddu, Anna La Salvia, Paola Ermacora, Laura Concas, Natalie Prinzi, Annalisa Fontana, Filippo de Braud, Salvatore Tafuto, Giuseppe Lo Russo, Vincenzo Mazzaferro, Francesca Spada, Rossana Berardi, Dario Giuffrida, Emilio Bajetta, Maria Rinzivillo, P. Razzore, Claudio Vernieri, Antongiulio Faggiano, Luca Giacomelli, Francesco Panzuto, Vittorio Perfetti, Massimo Di Maio, Francesca Aroldi, Francesco Di Costanzo, Lorenzo Antonuzzo, Daniela Femia, Gianfranco Delle Fave, Massimo Milione, Silvio Ken Garattini, Carlo Carnaghi, Roberto Buzzoni, Nicole Brighi, Sara Cingarlini, Carolina Cauchi, Mariangela Torniai, Silvia Ortolani, Nicola Fazio, Chiara De Divitiis, Laura Catena, Ivana Puliafito, Federica Cavalcoli, Maria Pia Brizzi, Alberto Zaniboni, Sergio Ricci, Maria Vittoria Davì, Alberto Bongiovanni, Davide Campana, Toni Ibrahim, Riccardo Marconcini, Sara Massironi, Annamaria Colao
المساهمون: Pusceddu S, Vernieri C, Di Maio M, Marconcini R, Spada F, Massironi S, Ibrahim T, Brizzi MP, Campana D, Faggiano A, Giuffrida D, Rinzivillo M, Cingarlini S, Aroldi F, Antonuzzo L, Berardi R, Catena L, De Divitiis C, Ermacora P, Perfetti V, Fontana A, Razzore P, Carnaghi C, Davì MV, Cauchi C, Duro M, Ricci S, Fazio N, Cavalcoli F, Bongiovanni A, La Salvia A, Brighi N, Colao A, Puliafito I, Panzuto F, Ortolani S, Zaniboni A, Di Costanzo F, Torniai M, Bajetta E, Tafuto S, Garattini SK, Femia D, Prinzi N, Concas L, Lo Russo G, Milione M, Giacomelli L, Buzzoni R, Delle Fave G, Mazzaferro V, de Braud F., Pusceddu, Sara, Vernieri, Claudio, Di Maio, Massimo, Marconcini, Riccardo, Spada, Francesca, Massironi, Sara, Ibrahim, Toni, Brizzi, Maria Pia, Campana, Davide, Faggiano, Antongiulio, Giuffrida, Dario, Rinzivillo, Maria, Cingarlini, Sara, Aroldi, Francesca, Antonuzzo, Lorenzo, Berardi, Rossana, Catena, Laura, De Divitiis, Chiara, Ermacora, Paola, Perfetti, Vittorio, Fontana, Annalisa, Razzore, Paola, Carnaghi, Carlo, Davì, Maria Vittoria, Cauchi, Carolina, Duro, Marilina, Ricci, Sergio, Fazio, Nicola, Cavalcoli, Federica, Bongiovanni, Alberto, La Salvia, Anna, Brighi, Nicole, Colao, Annamaria, Puliafito, Ivana, Panzuto, Francesco, Ortolani, Silvia, Zaniboni, Alberto, Di Costanzo, Francesco, Torniai, Mariangela, Bajetta, Emilio, Tafuto, Salvatore, Garattini, Silvio Ken, Femia, Daniela, Prinzi, Natalie, Concas, Laura, Lo Russo, Giuseppe, Milione, Massimo, Giacomelli, Luca, Buzzoni, Roberto, Delle Fave, Gianfranco, Mazzaferro, Vincenzo, de Braud, Filippo
المصدر: Gastroenterology. 155(2)
سنة النشر: 2017
مصطلحات موضوعية: 0301 basic medicine, Male, Time Factors, endocrine system diseases, Chemoprevention, Drug, Insulin Resistance, Pancreas, Adolescent, Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Child, Diabetes Mellitus, Type 2, Disease-Free Survival, Everolimus, Female, Humans, Hypoglycemic Agents, Italy, Kaplan-Meier Estimate, Metformin, Middle Aged, Neuroendocrine Tumors, Pancreatic Neoplasms, Retrospective Studies, Somatostatin, Treatment Outcome, Young Adult, Hepatology, Gastroenterology, Lanreotide, 80 and over, Diabetes Mellitus, Type 2, Antineoplastic Agent, chemistry.chemical_compound, 0302 clinical medicine, Retrospective Studie, Medicine, Pancrea, Hazard ratio, Pancreatic Neoplasm, Everolimu, 030220 oncology & carcinogenesis, Neuroendocrine Tumor, medicine.drug, Human, medicine.medical_specialty, Time Factor, 03 medical and health sciences, Insulin resistance, Internal medicine, Diabetes mellitus, Progression-free survival, Hypoglycemic Agent, business.industry, nutritional and metabolic diseases, Type 2 Diabetes Mellitus, medicine.disease, 030104 developmental biology, chemistry, business
الوصف: 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.
وصف الملف: STAMPA
تدمد: 1528-0012
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0dcfecbab2c6a6d2cb38f547e8767c26
https://pubmed.ncbi.nlm.nih.gov/29655834
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....0dcfecbab2c6a6d2cb38f547e8767c26
قاعدة البيانات: OpenAIRE
الوصف
تدمد:15280012