Metformin use and lung cancer survival: a population-based study in Norway
Menée à partir des données du registre norvégien des cancers portant sur 22 324 patients atteints d'un cancer du poumon diagnostiqué entre 2005 et 2014, cette étude de cohorte analyse l'association entre une utilisation de metformine, avant et après le diagnostic de cancer, et la survie globale et spécifique
Background : We assessed associations between metformin use and survival in a nationwide Norwegian cohort of lung cancer (LC) patients. Methods : The study linked 22,324 LC patients from the Cancer Registry of Norway diagnosed 2005–2014 with the Norwegian Prescription Database. We estimated associations of pre- and post-diagnostic metformin use with overall survival (OS) and LC-specific survival (LCSS) using multivariable time-fixed and time-dependent Cox regression. Results : Pre-diagnostic metformin use was not associated with improved survival in all patients. Nevertheless, pre-diagnostic metformin use was associated with better LCSS in squamous cell carcinoma (SCC) patients (hazard ratio (HR) = 0.79; 95% confidence interval (CI) 0.62–0.99) and in patients with regional stage SCC (HR = 0.67; 95%CI 0.47–0.95). Post-diagnostic metformin use was associated with improved LCSS in all patients (HR = 0.83; 95%CI 0.73–0.95), in patients with SCC (HR = 0.75; 95%CI 0.57–0.98), regional stage LC (HR = 0.74; 95%CI 0.59–0.94), and regional stage SCC (HR = 0.57; 95%CI 0.38–0.86). OS showed similar results. Analyses of cumulative use showed a dose-response relationship in all patients, patients with adenocarcinoma and SCC, and with regional and metastatic LC. Conclusions : Metformin use was associated with improved survival, especially LCSS in patients with regional stage SCC. Further prospective studies are required to clarify the role of metformin in LC treatment.