The Association between Metformin and the Cancer-Specific Mortality Rate in Nasopharyngeal Cancer Patients: Real-World Evidence

Yen Hsu; Chung Y Hsu; Yung-Shuo Kao

doi:10.3390/curroncol30040298

The Association between Metformin and the Cancer-Specific Mortality Rate in Nasopharyngeal Cancer Patients: Real-World Evidence

Curr Oncol. 2023 Mar 30;30(4):3940-3950. doi: 10.3390/curroncol30040298.

Authors

Yen Hsu¹, Chung Y Hsu², Yung-Shuo Kao³

Affiliations

¹ Department of Family Medicine, Changhua Christian Hospital, Changhua 500, Taiwan.
² Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan.
³ Department of Radiation Oncology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan.

Abstract

Objectives: Nasopharyngeal cancer is a common cancer in East and South Asia. The radiotherapy and chemotherapy regimen has advanced in recent years. However, many patients still suffer from local recurrence and distant metastasis; thus, identifying medication that can be combined with standard treatment to improve the treatment outcomes in nasopharyngeal cancer patients is an unmet need.

Methods: We included nasopharyngeal cancer patients from the Taiwan National Health Insurance Database (NHIRD). The primary endpoint was set as the cancer-specific mortality rate. Metformin cohorts and non-Metformin cohorts were matched by sex, age, and the year of the index date. Propensity score matching with a ratio of 1:1 was applied.

Results: A total of 6078 subjects were included in the study, with 3039 patients in each group. Male participants outnumbered female participants. Most of the patients were aged 50 to 64; the mean age was 60.4 ± 10.4 years in Metformin non-users, and that of Metformin users was 59.9 ± 10.5 years. Metformin users had a lower risk of death due to nasopharyngeal cancer (adjusted HR = 0.80; 95% CI = 0.71, 0.90) than controls.

Conclusions: We concluded that Metformin might be effective at reducing the cancer-specific mortality rate in nasopharyngeal cancer patients. Further randomized control trials should be completed.

Keywords: Metformin; cohort study; nasopharyngeal cancer; survival analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Female
Humans
Hypoglycemic Agents / therapeutic use
Male
Metformin* / therapeutic use
Middle Aged
Nasopharyngeal Carcinoma / drug therapy
Nasopharyngeal Neoplasms* / drug therapy
Retrospective Studies

Substances

Metformin
Hypoglycemic Agents

Grants and funding

This study was supported in part by the Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW110-TDU-B-212-124004) and China Medical University Hospital (DMR-111-105). We are grateful to the Health Data Science Center, China Medical University Hospital, for providing administrative, technical, and funding support. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.