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Adding Metformin to CCRT Does Not Improve Survival in NSCLC
Results from a randomized clinical trial suggest that adding metformin to concurrent chemoradiation (CCRT) does not improve survival in patients with unresectable stage III non-small cell lung cancer (NSCLC; JAMA Oncol. 2022:e212318.).
“Non–small cell lung cancer (NSCLC) has relatively poor outcomes. Metformin has significant data supporting its use as an antineoplastic agent,” explained Heath Skinner, MD, PhD, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, and colleagues.
This open-label, phase 2 study was conducted across multiple institutions. Patients with unresectable stage III NSCLC, were stratified by performance status, histology, and stage.
The primary outcome was 1-year progression-free survival (PFS), while secondary end points were overall survival (OS), time to local-regional recurrence, time to distant metastasis, and toxicity per Common Terminology Criteria for Adverse Events, version 4.03.
A total of 81 patients were in the control group, while 86 received metformin. The median follow-up amongst living patients was 27.7 months. The one-year PFS and OS rates in the control group were 60.4% (95% CI, 48.5%-70.4%) and 80.2% (95% CI, 69.3%-87.6%), respectively. Meanwhile, the metformin group saw a one-year PFS rate of 51.3% (95% CI, 39.8%-61.7%) and an OS of 80.8% (95% CI, 70.2%-87.9%)
Furthermore, there were no notable differences in local-regional recurrence or distant metastasis at 1 or 2 years, nor were there any significant differences in adverse events amongst both groups.
“In this randomized clinical trial, the addition of metformin to concurrent chemoradiation was well tolerated but did not improve survival among patients with unresectable stage III NSCLC,” concluded Dr Skinner et al.
