ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2019
Body Mass Index Influences the Salutary Effects of Metformin on Survival After Lobectomy for Stage I NSCLC.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Impact of concomitant medications on the efficacy of immune checkpoint inhibitors: an umbrella review.Frontiers in immunology · 2023Pooled it
- Obesity Promotes Lung Carcinogenesis Through Airway Immune Dysfunction.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2026Article
- Immune checkpoints and immunoregulation in metabolic diseases and cancers: pathological mechanisms and therapeutic potential.Signal transduction and targeted therapy · 2026Review
- AI-derived body composition analysis reveals muscle volume and metformin-associated adipose effects and the obesity paradox in non-small cell lung cancer.EBioMedicine · 2025Article
- Obesity-specific improvement of lung cancer outcomes and immunotherapy efficacy with metformin.Journal of the National Cancer Institute · 2025Article
- Metformin: A Dual-Role Player in Cancer Treatment and Prevention.International journal of molecular sciences · 2024Review
- Translating Molecular Biology Discoveries to Develop Targeted Cancer Interception in Barrett's Esophagus.International journal of molecular sciences · 2023Review
- Article
- Obesity and lung cancer-a narrative review.Journal of thoracic disease · 2023Review
- Association between visceral obesity, metformin use, and recurrence risk in early-stage colorectal cancer.Scientific reports · 2023Article
- Addition of metformin for non-small cell lung cancer patients receiving antineoplastic agents.Frontiers in pharmacology · 2023Article
- Research progress on the therapeutic effect and mechanism of metformin for lung cancer (Review).Oncology reports · 2023Review
- Identification of patient characteristics associated with survival benefit from metformin treatment in patients with stage I non-small cell lung cancer.The Journal of thoracic and cardiovascular surgery · 2022Article
- Imaging Memory T-Cells Stratifies Response to Adjuvant Metformin Combined with αPD-1 Therapy.International journal of molecular sciences · 2022Article
- Model established based on blood markers predicts overall survival in patients after radical resection of types II and III adenocarcinoma of the esophagogastric junction.World journal of gastrointestinal surgery · 2022Article
- Will We Unlock the Benefit of Metformin for Patients with Lung Cancer? Lessons from Current Evidence and New Hypotheses.Pharmaceuticals (Basel, Switzerland) · 2022Review
- Obesity-Specific Association of Statin Use and Reduced Risk of Recurrence of Early Stage NSCLC.JTO clinical and research reports · 2021Article
- Visceral Obesity Promotes Lung Cancer Progression-Toward Resolution of the Obesity Paradox in Lung Cancer.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2021Article
- Prior Treatment for Non-small Cell Lung Cancer Is Associated With Improved Survival in Patients who Undergo Definitive Stereotactic Body Radiation Therapy for a Subsequent Lung Malignancy: A Retrospective Multivariate and Matched Pair Analysis.American journal of clinical oncology · 2021Article
- Pleiotropic Effects of Metformin on the Antitumor Efficiency of Immune Checkpoint Inhibitors.Frontiers in immunology · 2020Review
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
introductionMetformin, a common medication used in the treatment of diabetes mellitus is known to have anticancer effects. We hypothesized that the salutary effect of metformin on the survival of patients with stage I NSCLC is influenced by body mass index (BMI).
methodsPatients undergoing lobectomy for stage I NSCLC without neoadjuvant therapy were included. Univariate and multivariate survival analyses to examine the association between metformin use and overall survival (OS), disease-specific survival (DSS), and recurrence-free survival were performed, stratified by BMI (>25 kg/m
resultsFour hundred thirty-four stage I patients (including 74 metformin users) were deemed eligible for analysis. Univariate and multivariate analysis revealed an association between metformin use and OS (hazard ratio [HR] = 0.52; p = 0.04) as well as DSS (HR = 0.21; p = 0.04) but not recurrence-free survival (HR = 0.67; p = 0.33) in high-BMI patients only. In a separate cohort of 205 patients with tumors of all stages (including 35 metformin users), downregulation of immune checkpoint gene expression (programmed cell death 1, cytotoxic T-lymphocyte associated protein 4, B and T lymphocyte associated, CD27 molecule, lymphocyte activating 3, and inducible T cell costimulator) in metformin users was seen only in high-BMI patients, with upregulation of these genes seen in low-BMI patients with metformin use.
conclusionsMetformin use may be associated with better OS and DSS only in high-BMI patients. This hypothesis is supported by gene expression data of immune checkpoint genes in metformin users using a separate cohort of advanced-stage tumors. Further studies examining the interaction of BMI with metformin in NSCLC are worthwhile.
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Registered trials
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