Evaluation of the effect of metformin as a radiosensitiser in solid tumours: A systematic review

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2025-02-10 DOI:10.1016/j.ctro.2025.100930

Elísabet González del Portillo , Alejandro Olivares-Hernández , Luis Corral Gudino , Laura Corvo Félix , Lorena Bellido Hernández , Luis Posado Domínguez , David León Jiménez , Rogelio González Sarmiento , Edel del Barco Morillo , Emilio Fonseca Sánchez , José Pablo Miramontes-Gonzáleze

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Abstract

Background

Metformin is an antidiabetic drug that has shown its benefit in increasing the effect of radiotherapy in the treatment of solid tumors in preclinical studies. The objective of this systematic review is to study the effect of metformin as a radiosensitizer in studies carried out in clinical practice.

Methods

Systematic review carried out according to PRISMA criteria of clinical trials, systematic reviews and observational studies focused on the influence of metformin as a radiosensitizer in solid tumors. The studies were published between the years 2010 and 2022. The results of the studies have been analyzed in terms of survival (OS, PFS, DFS, DMFS) and response (ORR) between patients treated with metformin and without it.

Results

A total of 16 studies have been found in the literature (the most frequent tumor was prostate cancer, 5 studies). External radiotherapy was administered in all the studies and in two of them to greater brachytherapy. The use of metformin with radiotherapy showed a consistent benefit in terms of survival and response in tumors of prostate, hepatic and gynecological origin. The benefit in the rest of the tumors analyzed (lung, rectal, and head and neck cancer) is doubtful, and the results are contradictory. The greatest benefits were observed in prostate tumors both in OS and SLE.

Conclusions

The use of metformin in combination with radiotherapy in solid tumors is one of the most promising treatments under development in oncology. The benefit observed in real-life studies makes it necessary to develop clinical trials that specifically evaluate its use in clinical practice in the future.

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评价二甲双胍作为放射增敏剂在实体肿瘤中的作用：一项系统综述

背景：二甲双胍是一种抗糖尿病药物，在临床前研究中显示其在提高实体瘤放疗效果方面的益处。本系统综述的目的是研究二甲双胍作为放射增敏剂在临床实践中所进行的研究中的效果。方法根据PRISMA标准对二甲双胍作为放射增敏剂对实体瘤的影响进行临床试验、系统评价和观察性研究。这些研究发表于2010年至2022年之间。对研究结果进行了二甲双胍治疗和不治疗患者的生存（OS， PFS， DFS， DMFS）和反应（ORR）分析。结果文献共发现16例，其中以前列腺癌最常见，5例。在所有的研究中都进行了外放射治疗，其中两项是近距离放疗。二甲双胍联合放疗在前列腺、肝脏和妇科肿瘤的生存和反应方面显示出一致的益处。对其他肿瘤（肺癌、直肠癌和头颈癌）的分析是否有益值得怀疑，而且结果是相互矛盾的。在前列腺肿瘤中观察到最大的益处，无论是OS还是SLE。结论二甲双胍联合放疗治疗实体瘤是肿瘤学研究中最有前途的治疗方法之一。在现实生活研究中观察到的益处使得有必要开展临床试验，专门评估其在未来临床实践中的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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