A Cohort Study of Exposure to Antihyperglycemic Therapy and Survival in Patients with Lung Cancer

Edvardas Danila, Donata Linkevičiūtė-Ulinskienė, Rolandas Zablockis, Vygantas Gruslys, Saulius Cicėnas and Giedrė Smailytė
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Edvardas Danila: Clinic of Chest Diseases, Immunology and Allergology of Faculty of Medicine of Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania
Donata Linkevičiūtė-Ulinskienė: Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Čiurlionio g. 21, Vilnius LT-08661, Lithuania
Rolandas Zablockis: Clinic of Chest Diseases, Immunology and Allergology of Faculty of Medicine of Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania
Vygantas Gruslys: Clinic of Chest Diseases, Immunology and Allergology of Faculty of Medicine of Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania
Saulius Cicėnas: Department of Thoracic Surgery and Oncology, National Cancer Institute, Santariškių g. 1, Vilnius LT-08660, Lithuania
Giedrė Smailytė: Laboratory of Cancer Epidemiology, National Cancer Institute, P. Baublio g. 3b, Vilnius LT-08406, Lithuania

IJERPH, 2020, vol. 17, issue 5, 1-12

Abstract: We evaluated the effect of antihyperglycemic therapy on the survival of patients with lung cancer (LC). The analysis included patients with LC and concomitant type 2 diabetes. 15,929 patients were classified into five groups: metformin users, insulin users, metformin and insulin users, sulphonylurea users and non-diabetic group. A multivariate analysis showed that exposure to either metformin or to insulin was associated with a lower risk of LC-specific mortality, and this approached statistical significance (HR 0.82, 95% CI 0.72–92 for metformin and HR 0.65, 95% CI 0.44–95 for insulin). When deaths from all causes were considered, only metformin exposure was associated with a significantly lower risk of death (HR 0.82, 95% CI 0.73–0.92). Users of sulphonylurea were at a higher risk of LC-specific and overall mortality (HRs 1.19, 95% CI 0.99–1.43 and 1.22, 95% CI 1.03–1.45). Our study shows a positive effect of metformin on the survival of patients with LC. Moreover, our results show that exposure to insulin was associated with a lower risk of LC-specific mortality, but not with deaths from all causes. The study results suggested that users of sulphonylurea may be at a higher risk of LC-specific and overall mortality.

Keywords: diabetes; insulin; lung cancer; metformin (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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