Effect of metformin on survival outcomes in diabetic patients with triple receptor-negative breast cancer.
Effect of metformin on survival outcomes in diabetic patients with triple receptor-negative breast cancer.
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DOI：
10.1002/cncr.26439
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发表时间：
2012-03-01
期刊：
影响因子：
6.2
通讯作者：
Gonzalez-Angulo AM
中科院分区：
文献类型：
--
作者：
Bayraktar S;Hernadez-Aya LF;Lei X;Meric-Bernstam F;Litton JK;Hsu L;Hortobagyi GN;Gonzalez-Angulo AM
最近的观察性研究表明，在糖尿病患者中使用二甲双胍可以降低癌症发病率和死亡率。二甲双胍的使用也是病理完全缓解的独立预测。我们探讨了在接受辅助化疗的三受体阴性乳腺癌(TNBC)患者中，二甲双胍的使用与生存结果之间的关系。德克萨斯大学M.D.安德森癌症中心的乳腺癌管理系统数据库确定了1995至2007年间接受TNBC辅助化疗的1448名女性。根据糖尿病状况和二甲双胍的使用情况对患者进行分类。采用Kaplan-Meier积限值法计算无远处转移生存率(DMFS)、无复发生存率(RFS)和总生存率(OS)。COX比例风险模型适合于确定二甲双胍的使用与生存结果之间的关联。我们的研究队列包括63名服用二甲双胍的糖尿病患者、67名未服用二甲双胍的糖尿病患者和1318名非糖尿病患者。糖尿病组患者倾向于高龄(P=0.005)；更多的糖尿病患者是绝经后(P=0.0007)、黑人(P=0.0001)和肥胖(P<；0.0001)。中位随访62个月时，三组间5年DMF(P=0.23)、RFS(P=0.38)和OS(P=0.58)无显著差异。与二甲双胍组相比，未服用二甲双胍的患者(危险比[HR]=1.63；95%CI：0.87~3.06；P=0.13)和非糖尿病患者(HR=1.62；95%CI：0.97~2.71；P=0.06)发生远处转移的风险更高。我们的研究结果表明，在辅助化疗期间使用二甲双胍并不会显著影响患有TNBC的糖尿病患者的生存结果。
Recent observational studies have shown that metformin use in diabetics decreases both cancer incidence and mortality. Metformin use is also independently predictive of pathologic complete response. We explored the association between metformin use and survival outcomes in patients with triple receptor-negative breast cancer (TNBC) receiving adjuvant chemotherapy. The Breast Cancer Management System database of The University of Texas M.D. Anderson Cancer Center identified 1448 women who received adjuvant chemotherapy for TNBC between 1995 and 2007. Patients were categorized by diabetes status and metformin use. Kaplan-Meier product limit method was used to calculate distant metastasis-free survival (DMFS), recurrence-free survival (RFS), and overall survival (OS). Cox proportional hazards models were fit to determine the association between metformin use and survival outcomes. Our study cohort consisted of 63 diabetic patients taking metformin, 67 diabetic patients not taking metformin, and 1318 non-diabetic patients. Patients in the diabetic groups tended to be older (P=0.005); more diabetic patients were postmenopausal (P=0.0007), black (P=0.0001), and obese (P < 0.0001). At a median follow-up of 62 months, there were no significant differences in 5-year DMFS (P=0.23), RFS (P=0.38), and OS (P=0.58) between the three groups. Compared to the metformin group, patients who did not take metformin (Hazard ratio [HR]=1.63; 95% CI:0.87 to 3.06; P=0.13) and nondiabetics (HR=1.62; 95% CI:0.97 to 2.71; P=0.06) tended to have a higher risk of distant metastases. Our findings suggest that metformin use during adjuvant chemotherapy does not significantly impact survival outcomes in diabetic patients with TNBC.
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影响因子：
3.8
作者：
Garwood, Elisabeth R.;Kumar, Anjali S.;Baehner, Frederick L.;Moore, Dan H.;Au, Alfred;Hylton, Nola;Flowers, Chris I.;Garber, Judy;Lesnikoski, Beth-Ann;Hwang, E. Shelley;Olopade, Olofunmilao;Port, Elisa Rush;Campbell, Michael;Esserman, Laura J.
通讯作者：
Esserman, Laura J.
影响因子：
3
作者：
Fleming, ST;Rastogi, A;Johnson, KD
通讯作者：
Johnson, KD
影响因子：
5
作者：
Coughlin, SS;Calle, EE;Thun, MJ
通讯作者：
Thun, MJ
影响因子：
3.8
作者：
Brown, Kristy A.;Hunger, Nicole I.;Simpson, Evan R.
通讯作者：
Simpson, Evan R.
影响因子：
158.5
作者：
Calle, EE;Rodriguez, C;Thun, MJ
通讯作者：
Thun, MJ