Metformin worth considering in diabetes patients with breast cancer
medwireNews: Post-hoc analysis of a trial of adjuvant treatment in women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer supports the contention that metformin treatment may extend survival in those who also have diabetes.
Patients who had diabetes but did not receive metformin, comprising 2.2% of the total 8381 patients, had significantly worse disease-free and overall survival than patients without diabetes, after accounting for confounders. But survival in women who received metformin (3.1% of patients) was on a par with that of the nondiabetic patients. Conversely, patients using insulin had poorer survival than nonusers.
The worse outcomes for diabetes patients and insulin users, as well as the benefits with metformin, were restricted to patients with hormone receptor-positive breast cancer.
Writing in the Journal of Clinical Oncology, Evandro de Azambuja (Institut Jules Bordet in Brussels, Belgium) and study co-authors note that the strength of evidence for the effect of diabetes medications is relatively low. Nevertheless, they suggest that “for patients with diabetes and HER2-positive and hormone receptor–positive disease, it is reasonable to recommend metformin treatment if patients have not already received treatment and to avoid as much as possible insulin use.”
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