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04-10-2019 | Oncology | News | Article

Metformin prolongs PFS in patients with EGFR-mutated lung adenocarcinoma

medwireNews: Research published in JAMA Oncology shows that patients with EGFR-mutated lung adenocarcinoma have prolonged progression free survival (PFS) when tyrosine kinase inhibitor (TKI) treatment is supplemented with metformin.

Oscar Arrietta (Instituto Nacional de Cancerologia, Mexico City) and study co-authors say: “[T]he use of metformin as concomitant treatment of lung adenocarcinoma can be a valuable addition to improve clinical outcomes.”

All 139 study participants received standard doses of EGFR–TKIs – erlotinib, afatinib, or gefitinib – and 69 individuals additionally received the repurposed anti-cancer drug metformin hydrochloride 500 mg twice daily.

During the median follow-up of 16.9 months, the median PFS among patients treated with EGFR–TKIs plus metformin was 13.1 months, compared with 9.9 months among those treated with EGFR–TKIS alone.

This translated to a 40% reduction in the risk for progression or death with the addition of metformin, explain the researchers.

Patients taking metformin also benefited from a significantly longer overall survival, at a median of 31.7 months versus 17.5 months, and a higher objective response rate of 71.0% versus 54.3%.

The researchers note that patients taking supplemental metformin were more likely to respond to EGFR–TKIs than those taking EGFR–TKIs alone (71.0 vs 54.3%), and without an increased risk for adverse events.

Arrietta and colleagues acknowledge, however, that their results were limited because patient populations were not stratified for smoking status, EGFR mutation profile, or EGFR–TKI, and patients had received previous “non-TKIs” before the study began.

They conclude: “The results from this phase 2 study warrant the design of a larger, phase 3, placebo-controlled study to draw more robust conclusions,” with the caveat that they “include a stratified randomization with treatment naive nondiabetic patients and with a mixed design that allows the simultaneous assessment of potential biomarkers.”

By Hannah Kitt

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

JAMA Oncol 2019; doi:10.1001/jamaoncol.2019.2553

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