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ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

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Meta-Analysis

Metformin has no Significant Anticancer Effect on Patients with Advanced or Unresectable Cancer: A Systematic Review and Meta-analysis

Author(s): Xinyan Gan, Chang Cao, Yan He, Xiaolin Hu, Xingchen Peng and Yonglin Su*

Volume 28, Issue 16, 2022

Published on: 20 May, 2022

Page: [1351 - 1358] Pages: 8

DOI: 10.2174/1381612828666220329113434

Price: $65

Abstract

Background: At present, the antitumor effect of metformin is controversial. Previous meta-analyses included observational studies, of which the results can be influenced by many confounders, affecting the result of meta-analyses and weakening the strength of evidence. Therefore, we conducted a meta-analysis to confirm the effect of metformin use on patients with advanced or unresectable cancers, including randomized clinical trials (RCTs).

Methods: We searched for RCTs in accordance with the inclusion and exclusion criteria. A meta-analysis was conducted to combine hazard ratios (HRs) or risk ratios (RRs) and their 95% confidence intervals (CIs) using a random-effects model.

Results: Finally, 7 eligible RCTs were included in the meta-analysis. Overall, the combined results revealed that treatment with metformin did not improve the overall survival (OS) of patients (HR, 1.12; 95% CI, 0.91-1.37, p>0.05), and there was no clear evidence that metformin use was related to improved progression-free survival (PFS) (HR, 1.17; 95% CI, 0.97-1.40; p>0.05). The pooled RR for grade III or IV adverse events was 0.92 (95% CI, 0.52- 1.60; p>0.05), indicating that the use of metformin was not significantly related to increased toxicity.

Conclusion: Metformin does not significantly improve the survival of patients with advanced or unresectable cancer, regardless of cancer type and region.

Keywords: Metformin, cancer, randomized clinical trials, overall survival, progression-free survival, meta-analysis.

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