Metformin use is associated with longer survival in glioblastoma patients with MGMT gene silencing

Purpose New treatments are needed to improve the overall survival of patients with glioblastoma Metformin is known for anti-tumorigenic effects in cancers, including breast and pancreas cancers. In this study, we assessed the association between metformin use and overall survival in glioblastoma pat...

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Bibliographic Details
Published in:Journal of neuro-oncology 2023-10, Vol.165 (1), p.209-218
Main Authors: Mohammad, Amro H., Jatana, Sukhdeep, Ruiz-Barerra, Miguel Angel, Khalaf, Roy, Al-Saadi, Tariq, Diaz, Roberto J.
Format: Article
Language:English
Subjects:
Antidiabetics
Biopsy
Brain cancer
Cancer
Diabetes
Diabetes mellitus (non-insulin dependent)
DNA methylation
DNA methyltransferase
Drug dosages
Gene silencing
Glioblastoma
Glucose
Hemoglobin
Hospitals
Hyperglycemia
Insulin
Kinases
Medicine
Medicine & Public Health
Metformin
Methylguanine
Multivariate analysis
Mutation
Neurology
Neurosurgery
O6-methylguanine-DNA methyltransferase
Oncology
Patients
Plasma
Statistical analysis
Survival
Toxicity
Tumors
Variables
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Summary:Purpose New treatments are needed to improve the overall survival of patients with glioblastoma Metformin is known for anti-tumorigenic effects in cancers, including breast and pancreas cancers. In this study, we assessed the association between metformin use and overall survival in glioblastoma patients. Methods We retrospectively studied 241 patients who underwent surgery at diagnosis of glioblastoma between 2014 and 2018. Metformin was used for pre-existing type 2 diabetes mellitus or in the prevention or management of glucocorticoid induced hyperglycemia. Kaplan-Meier curves and log-rank p test were used for univariate analysis. Cox-proportional hazards model was used to generate adjusted hazard ratios for multivariate analysis. Results Metformin use was associated with longer survival in patients with tumors that had a methylated O6-methylguanine DNA methyltransferase gene (MGMT) promoter (484 days 95% CI: 56–911 vs. 394 days 95% CI: 249–538, Log-Rank test: 6.5, p =  0.01). Cox regression analysis shows that metformin associates with lower risk of death at 2 years in patients with glioblastoma containing a methylated MGMT promoter (aHR = 0.497, 95% CI 0.26–0.93, p = 0.028). Conclusion Our findings suggest a survival benefit with metformin use in patients with glioblastomas having methylation of the MGMT promoter.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-023-04485-2