ArticleThoracic cancer2023
The effect of metformin or dipeptidyl peptidase 4 inhibitors on clinical outcomes in metastatic non-small cell lung cancer treated with immune checkpoint inhibitors.
Article in Thoracic cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Impact of concomitant medications on the efficacy of immune checkpoint inhibitors: an umbrella review.Frontiers in immunology · 2023Pooled it
- Metformin enhances survival with immune checkpoint inhibitors in cancer patients: A meta-analysis.Oncology letters · 2026Article
- Prognostic Impact of DPP4 Inhibitors on Systemic Drug Therapy for Advanced Kidney Cancer Patients.Cancer science · 2026Article
- Effect of type 2 diabetes mellitus on systemic treatment for advanced non-small cell lung cancer.Translational lung cancer research · 2025Article
- Effects of Metformin on Survival and Toxicity in Patients with Metastatic Non-Small Cell Lung Cancer Treated with Nivolumab.Medicina (Kaunas, Lithuania) · 2025Article
- Obesity-specific improvement of lung cancer outcomes and immunotherapy efficacy with metformin.Journal of the National Cancer Institute · 2025Article
- DPP4, a potential tumor biomarker, and tumor therapeutic target: review.Molecular biology reports · 2025Review
- Concomitant medication effects on patients with lung cancer taking immune checkpoint inhibitors a review.Medical oncology (Northwood, London, England) · 2025Review
- CD26 as a potential therapeutic target for lung adenocarcinoma.Frontiers in oncology · 2025Article
- Harnessing Oxylipins and Inflammation Modulation for Prevention and Treatment of Colorectal Cancer.International journal of molecular sciences · 2024Review
- Caloric restriction and metformin selectively improved LKB1-mutated NSCLC tumor response to chemo- and chemo-immunotherapy.Journal of experimental & clinical cancer research : CR · 2024Article
- Prognostic impact of metformin in solid cancer patients receiving immune checkpoint inhibitors: novel evidences from a multicenter retrospective study.Frontiers in pharmacology · 2024Article
- Immune Checkpoint Inhibitors and the Exposome: Host-Extrinsic Factors Determine Response, Survival, and Toxicity.Cancer research · 2023Review
- Comedications with Immune Checkpoint Inhibitors: Involvement of the Microbiota, Impact on Efficacy and Practical Implications.Cancers · 2023Review
- Addition of metformin to non-small-cell lung cancer patients with or without diabetes.Thoracic cancer · 2023Article
- The effect of metformin or dipeptidyl peptidase 4 inhibitors on clinical outcomes in metastatic non-small cell lung cancer treated with immune checkpoint inhibitors.Thoracic cancer · 2023Article
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreclinical data have shown the immunomodulatory effects of metformin and dipeptidyl peptidase 4 (DPP4) inhibitors in patients with diabetes. However, its clinical impact remains unclear in lung cancer.
methodsBetween 2017 and 2021, 466 patients received ICI monotherapy. Patients were categorized into concurrent (MET; metformin or combination of metformin and DPP4 inhibitor) and without concomitant (NMET; nonmetformin/DPP4 inhibitors) administration of metformin and DPP4 inhibitors groups at least 8 weeks before and during ICI therapy. The primary objectives were the objective response rate (ORR) and progression-free survival (PFS). The second objective was to evaluate the overall survival (OS) and the occurrence of immune-related adverse events (irAEs).
resultsAmong 466 patients, 89 (19.0%) and 377 (81%) were categorized into the MET and NMET groups, respectively. MET group had a significantly higher ORR (MET group: 24.7% vs. NMET group: 14.8%, p = 0.025) and longer PFS than those in the NMET group (MET group 5.1 month vs. NMET group 2.8 months, p = 0.018). After patients were stratified based on the prior line of therapy and PD L1 expression status, the PFS of the second-line therapy and PD L1 ≥50 was significantly higher in the MET than in the NMET group. The proportion of patients experiencing all-grade irAEs was numerically higher in the MET group (19.1%) than in the NMET group (14.3%), without statistical significance (p = 0.382).
conclusionsConcurrent use of metformin and DPP4 inhibitors with ICIs significantly improved the clinical outcomes without increasing the incidence of irAEs in NSCLC.
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