[ad_1]
According to the results of a randomized study presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in 2019, the addition of metformin to chemoradiotherapy treatment did not improve progression-free survival or overall survival in patients with locally advanced, non-treated non-small cell lung cancer (NSCLC).1
Metformin is a drug commonly used to treat diabetes and is involved
inhibition of mitochondrial respiration (although its mechanism of
the action is not fully understood). The results of the retrospective studies
suggested that its use is badociated with improved response rates in patients
with cancer receiving radiation therapy.2
In the Randomized Open-label Study NRG-LU001 (ClinicalTrials.gov Identifier: NCT02186847) – a Phase 2
trial on patients with stage IIIA / B untreated NSCLC – non-diabetic patients
were randomized to a ratio of 1: 1 to receive chest radiotherapy (60Gy)
with concomitant administration of carboplatin / paclitaxel combination
chemotherapy followed by carboplatin / paclitaxel chemotherapy, with or without
metformin hydrochloride (2,000 mg per day orally) administered before and during chemoradiotherapy,
as well as during consolidation chemotherapy. the
the main evaluation criterion of the study was SSP; OS was a secondary criterion.
Of the 170 patients included in the study, 84 and 86 were randomized.
attributed to metformin and control arms, respectively. Compared to
toxicity, there were similar levels of gastrointestinal, respiratory, vascular,
and metabolic adverse effects in both arms of the study. However, only 39% of patients
in the arm of metformin have completed the treatment with metformin as described in the study
protocol; many of the remaining patients required a change in dosage.
No significant difference in PFS was observed with the intention of
treat (ITT) the patient population between the 2 arms of the study (relative risk [HR],
1.15; P = .2441). In an unforeseen,
post-hoc badysis including patients who have completed treatment in accordance with
protocol, the median PFS was 15.4 months and 16.6 months for those receiving
metformin compared to those who have not been, respectively. Similarly, he did not have
significant difference in the SG between the 2 arms of the study in the ITT population,
although the two-year exploitation rate of 65.4% is higher than forecast for this product.
population.
While cancer mortality was 90% among patients in the control group
In this group, 71% of deaths in patients treated with metformin were attributed to
disease.
In conclusion, the presenter of the study noted that, although well tolerated, metformin did not improve SSP nor SG, and did not alter failure rates Local-regional or distant metastasis in patients with NSCLC.
Read more about Cancer Therapy AdvisorThe coverage of the ASCO Annual Meeting by visiting the conference page.
References
- Tsakiridis T, Hu C, Skinner HD, et al. Initial declaration of NRG-LU001 (NCT02186847), a randomized phase II trial of concomitant chemoradiotherapy (CRT) +/- metformin in locally advanced non-small cell lung cancer (NSCLC). Presented at the annual meeting of ASCO (American Society of Clinical Oncology); May 31 to June 3, 2019; Chicago, IL. Abstract 8502.
- Samsuri NAB, Leech M, Marignol L. Metformin and the improvement of treatment outcomes in radiotherapy – a review. Cancer Treat Rev. 2017 55: 150-162.
Source link
