Meta-Analysis Of The Therapeutic Efficacy And Survival Prognostic Risk Of Metformin For Stage Ⅲ-Ⅳ Non-Small Cell Lung Cancer Without Diabetes

Background and Objective:Lung cancer is the most common malignant tumor in China and even in the world.Although there have been new breakthroughs in the treatment of non-small cell lung cancer(targeted therapy and immune checkpoint inhibitors)in the past decade,the treatment effect is still not as expected,drug resistance force us to find new drugs at a faster pace.Metformin has been used as a first-line drug in the treatment of type 2 diabetes for nearly 60 years.In recent years,it has been found that metformin has the potential to inhibit the occurrence and development of tumors.However,the effect of metformin on prognosis in patients with stage III-IV non-diabetic lung cancer is clearly controversial.In this study,the effect of metformin combination therapy on prognosis and survival in patients with stage III-IV non-diabetic non-small cell lung cancer was comprehensively evaluated by means of a meta-analysis.Methods:Through to Pub Med,Embase,the Cochrane library,English database retrieval,hownet,VIP,Wan Fang datebase,Chinese biomedical literature database retrieval,the deadline is February 2020,search the related literature has been the subject,in strict accordance with the inclusion criteria,exclusion criteria set by the screening,finally select standard literature,to extract the needed data,application Rev Man5.3meta-analysis.Results:A total of 6 articles were included in this meta-analysis,and meta-analysis of the prognostic value of metformin showed that the disease control rate [OR=3.07,95% CI(1.28,7.36),P=0.01] was statistically significant.Progression-free survival[HR=0.64,95% CI(0.34,1.19),P=0.16],overall survival [HR=0.66,95% CI(0.38,1.15),P=0.15],objective response rate [OR=1.70,95% CI(0.77,3.77),P=0.19],one-year PFS rate [OR=0.83,95% CI(0.55,1.25),P=0.37],no statistically significant differences.Conclusions:Metformin combined therapy could improve the disease control rate of non-diabetic patients with stage III-IV non-small cell lung cancer,but there was no significant improvement in progression-free survival,overall survival,objective remission rate or one-year progression-free survival rate.