Metformin Beneficial in Lung Cancer Patients With Overweight, Obesity
TUESDAY, Dec. 10, 2024 -- In non-small cell lung cancer (NSCLC) patients with overweight or obesity, metformin may improve lung cancer-specific clinical outcomes, according to a study published online Nov. 19 in the Journal of the National Cancer Institute.
Randall J. Smith Jr., Ph.D., from the Roswell Park Comprehensive Cancer Center in Buffalo, New York, and colleagues retrospectively analyzed two clinical cohorts and employed contemporary mouse models to examine whether metformin could benefit NSCLC patients with overweight and obesity. One cohort included NSCLC patients with overweight body mass index (BMI) and nonoverweight BMI (511 and 232 individuals, respectively) who underwent lobectomy, and the second examined the effect of metformin on progression-free survival (PFS) after immune checkpoint inhibitor treatment in 284 NSCLC patients with overweight BMI versus 184 NSCLC patients with nonoverweight BMI.
The researchers found that in patients with overweight, there was an association for metformin with increased recurrence-free survival after lobectomy (hazard ratio, 0.47). In diet-induced obese mouse models, metformin corrected accelerated tumor growth in a lymphocyte-specific manner, while reversing certain mechanisms of immune suppression potentiated by obesity. In obese mice, programmed cell death 1 blockade coupled with metformin was more effective at limiting tumor burden; in patients with overweight on immunotherapy, metformin correlated with PFS (hazard ratio, 0.60).
"Our findings demonstrate a need for prospective studies of metformin's effects on high BMI individuals with advanced lung cancer, especially the growing population receiving checkpoint blockade therapy," the authors write.
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