Cancer Management and Research (May 2021)

Metformin Use and the Outcome of Metastatic Renal Cell Carcinoma Treated with Sunitinib or Pazopanib

  • Fiala O,
  • Ostašov P,
  • Rozsypalová A,
  • Hora M,
  • Šorejs O,
  • Šustr J,
  • Bendová B,
  • Trávníček I,
  • Filipovský J,
  • Fínek J,
  • Büchler T

Journal volume & issue
Vol. Volume 13
pp. 4077 – 4086

Abstract

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Ondřej Fiala,1,2 Pavel Ostašov,3 Aneta Rozsypalová,4 Milan Hora,5 Ondřej Šorejs,1,2 Jan Šustr,1 Barbora Bendová,5 Ivan Trávníček,5 Jan Filipovský,6 Jindřich Fínek,1 Tomáš Büchler4 1Department of Oncology and Radiotherapy, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic; 2Laboratory of Cancer Treatment and Tissue Regeneration, Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech, Czech Republic; 3Laboratory of Tumor Biology and Immunotherapy, Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech, Czech Republic; 4Department of Oncology, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; 5Department of Urology, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic; 6 2nd Department of Internal Medicine, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech RepublicCorrespondence: Ondřej FialaDepartment of Oncology and Radiotherapy, Faculty of Medicine and University Hospital Pilsen, Charles University Prague, Alej Svobody 80, Pilsen, CZ-304 60, Czech RepublicTel +42 0728655488Email [email protected]: The anticancer properties of metformin have been suggested in numerous experimental studies and several retrospective clinical studies show that its use is associated with improved outcome of patients with cancer. However, limited data are available for patients with metastatic renal cell carcinoma (mRCC) treated with targeted therapy. The aim of this retrospective study was to assess the impact of the metformin use on survival of mRCC patients treated with sunitinib or pazopanib.Methods: Clinical data from 343 patients with mRCC treated with sunitinib or pazopanib in the first line were analyzed. Progression-free survival (PFS) and overall survival (OS) were compared according to the use of metformin.Results: The median PFS and OS for patients using metformin was 31.1 (95% CI 20.6– 35.1) and 51.6 (95% CI 44.7-NR) months compared to 9.3 (95% CI 8.0– 12.0) and 22.4 (95% CI 19.4– 26.8) months for patients not using metformin (p< 0.0001 and p=0.0002, respectively). Cox multivariate analysis shows that the use of metformin remains a significant factor for PFS (HR=0.55 [95% CI 0.343– 0.883], p=0.013) and also for OS (HR=0.45 [95% CI 0.256– 0.794], p=0.006).Conclusion: The present study results suggest that the use of metformin was associated with favorable outcome of mRCC patients treated with sunitinib or pazopanib.Keywords: renal cell carcinoma, metformin, sunitinib, pazopanib, tyrosine kinase inhibitors, outcome

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