Concurrent Nivolumab and Metformin in Diabetic Cancer Patients: Is It Safe and More Active?
Aged
B7-H1 Antigen
/ antagonists & inhibitors
Diabetes Mellitus, Type 2
/ diagnosis
Female
Humans
Hypoglycemic Agents
/ adverse effects
Immune Checkpoint Inhibitors
/ adverse effects
Italy
Male
Metformin
/ adverse effects
Neoplasms
/ diagnosis
Nivolumab
/ adverse effects
Progression-Free Survival
Retrospective Studies
Time Factors
Immunotherapy
diabetic cancer patients
immune checkpoint inhibitor
metformin
nivolumab
safety
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
29
11
2021
revised:
10
01
2022
accepted:
12
01
2022
entrez:
27
2
2022
pubmed:
28
2
2022
medline:
8
3
2022
Statut:
ppublish
Résumé
Recent evidence suggests potential synergistic antitumor effects of the combination of programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors with the oral hypoglycemic agent metformin. The aim of this study was to investigate the safety and activity of metformin combined with nivolumab in diabetic cancer patients. Patients with advanced melanoma, renal cell carcinoma or lung cancer receiving nivolumab with concurrent diabetes treated with metformin were retrospectively collected. The primary endpoint was the safety of nivolumab plus metformin combination. We collected 40 patients with solid tumors who received metformin for concomitant diabetes and nivolumab as anticancer therapy in four Italian Hospitals. The concomitant use of nivolumab and metformin was well tolerated; adverse events (AEs) of any grade occurred in 75% of patients (mainly fatigue, pruritus, rash, and asthenia). Grade 3 AEs occurred only in 20% of cases; no grade 4 AEs were observed. A statistically significant correlation was found between higher doses of metformin (>1,000 mg daily) and longer progression-free survival (p=0.021), overall survival (p=0.037) and higher overall response rate. The combination of nivolumab and metformin was safe and might have an antitumor activity, supporting further investigations on the synergistic antitumor effect of this combination.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Recent evidence suggests potential synergistic antitumor effects of the combination of programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors with the oral hypoglycemic agent metformin. The aim of this study was to investigate the safety and activity of metformin combined with nivolumab in diabetic cancer patients.
PATIENTS AND METHODS
METHODS
Patients with advanced melanoma, renal cell carcinoma or lung cancer receiving nivolumab with concurrent diabetes treated with metformin were retrospectively collected. The primary endpoint was the safety of nivolumab plus metformin combination.
RESULTS
RESULTS
We collected 40 patients with solid tumors who received metformin for concomitant diabetes and nivolumab as anticancer therapy in four Italian Hospitals. The concomitant use of nivolumab and metformin was well tolerated; adverse events (AEs) of any grade occurred in 75% of patients (mainly fatigue, pruritus, rash, and asthenia). Grade 3 AEs occurred only in 20% of cases; no grade 4 AEs were observed. A statistically significant correlation was found between higher doses of metformin (>1,000 mg daily) and longer progression-free survival (p=0.021), overall survival (p=0.037) and higher overall response rate.
CONCLUSION
CONCLUSIONS
The combination of nivolumab and metformin was safe and might have an antitumor activity, supporting further investigations on the synergistic antitumor effect of this combination.
Identifiants
pubmed: 35220243
pii: 42/3/1487
doi: 10.21873/anticanres.15620
doi:
Substances chimiques
B7-H1 Antigen
0
CD274 protein, human
0
Hypoglycemic Agents
0
Immune Checkpoint Inhibitors
0
Nivolumab
31YO63LBSN
Metformin
9100L32L2N
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1487-1493Informations de copyright
Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.