二甲双胍辅助治疗晚期非小细胞肺癌疗效的Meta分析

Effect of metformin for advanced non-small cell lung cancer adjuvant therapy:A Meta-analysis

目的:系统评价二甲双胍联合标准一线方案治疗晚期非小细胞肺癌的疗效,为非小细胞肺癌的临床合理用药提供循证参考。方法:计算机检索Pubmed、Embase、Cochrane Library、Web of Science、中国生物医学文献、中国知网、万方、维普等数据库,收集关于二甲双胍对晚期非小细胞肺癌患者临床疗效影响的文献,采用Review Manager 5.3软件对结局指标总生存期(overall survival,OS)、无进展生存期(progression free survival,PFS)和客观缓解率(objective response rate,ORR)进行统计分析。结果:共纳入6篇随机对照研究和8篇队列研究,包含5030例患者。Meta分析结果显示,二甲双胍辅助治疗组的OS(HR=0.77,95%CI:0.69~0.86,P<0.0001)、PFS(HR=0.83,95%CI:0.72~0.96,P=0.01)以及ORR(RR=1.19,95%CI:1.04~1.35,P=0.008)均高于对照组。结论:二甲双胍对晚期非小细胞肺癌患者预后有积极作用,可提高患者的ORR,延长患者的PFS和OS时间。

Objective:To systematically evalute the efficacy of metformin combined with standard first-line therapy for patients with advanced non-small cell lung cancer(NSCLC),and to provide evidence-based reference for rational drug use of NSCLC.Methods:We searched databases,including Pubmed,Embase,Cochrane Library,Web of Science,CBM,CNKI,WANFANG and VIP,to collect clinical studies on the effect of metforminon combined with standard first-line therapy for patients with NSCLC.RevMan 5.3 software was used to perform the Meta-analysis.The end points included overall survival(OS),progression free survival(PFS),and objective response rate(ORR).Results:A total of 6 RCTs and 8 cohort studies were included in this study,totaling 5030 participants.According to Meta-analysis,significantly prolonged OS and PFS was found in metformin usage rather than non-metformin usage(OS:HR=0.77,95%CI:0.69~0.86,P<0.0001.PFS:HR=0.83,95%CI:0.72~0.96,P=0.01),such association was also presented in ORR(RR=1.19,95%CI:1.04~1.35,P=0.008).Conclusion:The use of metformin is positive for the prognosis of patients with advanced lung cancer.It may improve the ORR,PFS and OS time of patients.