Daha önce over kanseri riskini azalttığı bulunan Metforminin yeni yapılan araştırmada prostat kanseri olanlarda prostat kanserine bağlı ölüm riskini %24 azalttığı gösterildi. Bu çalışma prostat kanserlerinin metabolik tabiatta bir kanser olduğunu telkin etmekte.
Metformin (Glucophen) emniyetli, minimum yan etkili ve ucuz bir diyabet ilacı. Tip 2 diyabette ilk tedavi tercihi. Yapılan çalışmalar diyabetik olmayanlarda da metforminin ikincil korunmada etkili olabileceğini telkin etmekte.
3837 Diyabetik, 66 yaş üstü kanserli hastalar 4.64 yıl takip edilmiş ve hastaların %35’I ölmüş, hastaların %7.6 sı ise prostat kanserinden dolayı ölmüş. Metformin kullananlarda düzeltilmiş hasar oranı (adjusted hazard ratio) metformin kullanılan her altıay için 0.76 bulunmuş ( ölüm riski %24 azalmış).
The study was supported by the Canadian Cancer Society Research Institute, the Ontario Ministry of Health and Long-Term Care, the Canadian Institutes of Health Research (CIHR), the Canadian Patient Safety Institute, the Heart and Stroke Foundation of Ontario), and the Canadian Diabetes Association/CIHR-Institute of Nutrition, Metabolism and Diabetes. Dr. Margel, Dr. Mitsiades, Dr. Penney, and Dr. Stampfer report no relevant financial relationships. (J Clin Oncol.Published online August 5, 2013. Abstract)
©American Society of Clinical Oncology
Metformin Use and All-Cause and Prostate Cancer–Specific Mortality Among Men With Diabetes
David Margel⇑, David R. Urbach, Lorraine L. Lipscombe, Chaim M. Bell, Girish Kulkarni, Peter C. Austin and Neil Fleshner
Author Affiliations
David Margel, Girish Kulkarni, and Neil Fleshner, Princess Margaret Hospital, University Health Network; David Margel, David R. Urbach, Lorraine L. Lipscombe, Chaim M. Bell, and Peter C. Austin, University of Toronto; David R. Urbach, Toronto General Hospital Research Institute; David Margel, David R. Urbach, Lorraine L. Lipscombe, Chaim M. Bell, Girish Kulkarni, and Peter C. Austin, Institute for Clinical Evaluative Sciences; David R. Urbach, Cancer Care Ontario; and Chaim M. Bell, Mt Sinai Hospital, Toronto, Ontario, Canada.
Abstract
Purpose To evaluate the association between cumulative duration of metformin use after prostate cancer (PC) diagnosis and all-cause and PC-specific mortality among patients with diabetes.
Patients and Methods We used a population-based retrospective cohort design. Data were obtained from several Ontario health care administrative databases. Within a cohort of men older than age 66 years with incident diabetes who subsequently developed PC, we examined the effect of duration of antidiabetic medication exposure after PC diagnosis on all-cause and PC-specific mortality. Crude and adjusted hazard ratios (HRs) were calculated by using a time-varying Cox proportional hazard model to estimate effects.
Results The cohort consisted of 3,837 patients. Median age at diagnosis of PC was 75 years (interquartile range [IQR], 72 to 79 years). During a median follow-up of 4.64 years (IQR, 2.7 to 7.1 years), 1,343 (35%) died, and 291 patients (7.6%) died as a result of PC. Cumulative duration of metformin treatment after PC diagnosis was associated with a significant decreased risk of PC-specific and all-cause mortality in a dose-dependent fashion. Adjusted HR for PC-specific mortality was 0.76 (95% CI, 0.64 to 0.89) for each additional 6 months of metformin use. The association with all-cause mortality was also significant but declined over time from an HR of 0.76 in the first 6 months to 0.93 between 24 and 30 months. There was no relationship between cumulative use of other antidiabetic drugs and either outcome.
Conclusion Increased cumulative duration of metformin exposure after PC diagnosis was associated with decreases in both all-cause and PC-specific mortality among diabetic men.
Metformin intake is associated with better survival in ovarian cancer
Cancer. Published online December 3, 2012. Abstractl
A case-control study:Sanjeev Kumar MBBS1, Alexandra Meuter MD1, Prabin Thapa MS2, Carrie Langstraat MD1, Shailendra Giri PhD3, Jeremy Chien PhD3, Ramandeep Rattan PhD3, William Cliby MD1, Viji Shridhar PhD3,†,*
BACKGROUND:
The objective of this case-control study was to identify any association of metformin intake with the survival of patients with ovarian cancer.
METHODS:
In this retrospective case-control study, women with ovarian cancer who received metformin (cases) were compared with women with ovarian cancer who did not receive metformin (controls). A 2-layered analysis was conducted. In preliminary analysis, all cases (the OC cohort) were compared with controls at a 1:2 ratio. Subsequently, in definitive analysis, only patients who had epithelial ovarian cancer (the EOC cohort) were compared with controls at a 1:3 ratio. In the EOC cohort, cases were matched with controls for age (±5 years), International Federation of Gynecology and Obstetrics stage, and residual disease. Prognostic variables and disease specific survival were compared using chi-square tests, the Kaplan-Meier (log-rank) method, and Cox proportional hazards analysis.
RESULTS:
In a preliminary analysis of the OC cohort (72 cases and 143 controls), cases had better survival (5-year disease-specific survival for cases vs controls, 73% vs 44%; P = .0002). In the definitive analysis of the EOC cohort (61 cases and 178 controls), the distribution of age, disease stage, optimal cytoreduction, serous histology, and platinum chemotherapy remained similar between cases and controls (P > .05). Despite these similarities, cases had significantly better survival (5-year disease-specific survival for cases vs controls, 67% vs 47%; P = .007). On multivariate analysis, metformin remained an independent predictor of survival (hazard ratio, 2.2; 95% confidence interval, 1.2-3.8; P = .007) after controlling for disease stage, grade, histology, chemotherapy, body mass index, and surgical cytoreduction.
CONCLUSIONS:
The results of this study indicated an association of metformin intake with survival in patients with ovarian cancer. The receipt of metformin was associated with better survival, and the authors concluded that metformin is worthy of clinical trials in ovarian cancer. Cancer 2013. © 2012 American Cancer Society.