Print Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Park J, Chan S. Park J, & Chan S Park, Jamie, and Samuel Chan. Metformin may improve survival for advanced lung adenocarcinoma patients with higher BMI and taking EGFR-TKI therapy. 2 Minute Medicine, 25 January 2022. McGraw Hill, 2022. AccessMedicine. https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=580107§ionid=263959459APA Citation Park J, Chan S. Park J, & Chan S Park, Jamie, and Samuel Chan. Metformin may improve survival for advanced lung adenocarcinoma patients with higher bmi and taking egfr-tki therapy. [publicationyear2] 2 minute medicine. McGraw Hill. https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=580107§ionid=263959459.MLA Citation Park J, Chan S. Park J, & Chan S Park, Jamie, and Samuel Chan. "Metformin may improve survival for advanced lung adenocarcinoma patients with higher BMI and taking EGFR-TKI therapy." 2 Minute Medicine McGraw Hill, 2022, https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=580107§ionid=263959459. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Annotate Clip Autosuggest Results Metformin may improve survival for advanced lung adenocarcinoma patients with higher BMI and taking EGFR-TKI therapy by Jamie Park, Samuel Chan Listen +Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission. + 1. The overall progression-free survival (PFS) was 10.54 years. + 2. Patients with body mass weight (BMI) ≥ 24 derived greater survival benefit from metformin plus epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs), compared to EGFR-TKIs only. + Evidence Rating Level: 2 (Good) Study Rundown: + +Recently, metformin has been associated with reducing the mortality of various cancers. Due to its anti-tumour properties, there have been interests in evaluating whether metformin improves the efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatments in cancer patients. There have been several phase 2 trials with lack of consistent results due to variations of metformin doses used and the differences in patient demographics. Therefore, this post-hoc study of a phase 2 trial aimed to explore whether there is an association of body mass index (BMI) and the clinical benefits from metformin in patients with advanced lung adenocarcinoma receiving EGFR-TKIs. The improvement in progression-free survival (PFS) and overall survival (OS) from adding metformin to EGFR-TKIs was only seen in patients with BMI ≥ 24. Patients with BMI <24 did not show benefit for either PFS or OS. Limitations of the analyses include that this is a post hoc analysis, inability to include all patients from the initial trial that have incomplete data and the limited number of patients. Overall, this study demonstrated that BMI could be a key factor modulator of the effect of metformin and EGFR-TKIs for cancer therapy. However, further prospective investigation is required to confirm the association of BMI with metformin and EGFR-TKI synergy. + Click to read the study in JAMA Oncology + Relevant Reading: Effect of metformin plus tyrosine kinase inhibitors compared with tyrosine kinase inhibitors alone in patients with epidermal growth factor receptor-mutated lung adenocarcinoma: a phase 2 randomized clinical trial In-Depth [randomized controlled trial]: + +This was a post hoc analysis of a phase II study and included patients with epidermal growth factor receptor (EGFR) variant-positive non-small-cell lung cancer (NSCLC). Patients were randomized to receive EGFR-tyrosine kinase inhibitor (TKI) only or EGFR-TKI plus metformin. A total of 133 patients (mean age [SD]: 59.39 [13.07]) were included in the analysis. The overall progression-free survival (PFS) was 10.54 (95% confidence interval [CI]: 8.92-12.17). Patients with body mass weight (BMI) ≥ 24 showed statistically significant improvement in PFS from adding metformin to their EGFR-TKIs (15.83 months [95% CI: 9.93-21.73]), compared to EGFR-TKIs only (8.34 [95% CI: 6.09-10.59 months]). The corresponding hazard ratio was 0.4 (95% CI: 0.2-0.7, p=0.03). BMI ≥ 24 patients also showed improvement to OS from the addition of metformin to their EGFR-TKI therapy (31.44 [95% CI: 10.28-52.60 months]), compared to EGFR-TKIs only (18.00 [95% CI: 11.31-24.70 months). The corresponding hazard ratio was 0.55 (95% CI: 0.31-0.98, p=0.04). For patients with BMI <24, there was no statistically significant difference between metformin + TKI vs. TKI only (PFS p=0.65, OS p=0.68). +©2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.