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Impact of metformin use on the outcomes of newly diagnosed diffuse large B‐cell lymphoma and follicular lymphoma
Author(s) -
Wang Yucai,
Maurer Matthew J.,
Larson Melissa C.,
Allmer Cristine,
Feldman Andrew L.,
Bennani N. Nora,
Thompson Carrie A.,
Porrata Luis F.,
Habermann Thomas M.,
Witzig Thomas E.,
Ansell Stephen M.,
Slager Susan L.,
Nowakowski Grzegorz S.,
Cerhan James R.
Publication year - 2019
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.15997
Subject(s) - metformin , medicine , hazard ratio , follicular lymphoma , diffuse large b cell lymphoma , lymphoma , diabetes mellitus , confidence interval , body mass index , proportional hazards model , gastroenterology , oncology , endocrinology , insulin
Summary The diabetes mellitus (DM) drug metformin targets mechanistic/mammalian target of rapamycin and inhibits lymphoma growth in vitro . We investigated whether metformin affected outcomes of newly diagnosed diffuse large B‐cell (DLBCL, n = 869) and follicular lymphoma (FL, n = 895) patients enrolled in the Mayo component of the Molecular Epidemiology Resource cohort study between 2002 and 2015. Hazard ratios (HR) and 95% confidence intervals (CIs) adjusted for age, sex, body mass index, prognostic index and treatment were used to estimate the association of metformin exposure (No DM/No metformin; DM/No metformin; DM/Metformin) with event‐free (EFS), lymphoma‐specific (LSS) and overall (OS) survival. Compared to No DM/No metformin DLBCL patients, there was no association of DM/Metformin ( n = 48; HR = 1·05, 95% CI 0·59–1·89) or DM/No metformin( n = 54; HR = 1·41, 95% CI 0·88–2·26) with EFS; results were similar for LSS and OS. Compared to No DM/No metformin FL patients, there was no association of DM/Metformin ( n = 37; HR = 1·16, 95% CI 0·71–1·89) or DM/No metformin ( n = 19; HR = 1·16, 95% CI 0·66–2·04) with EFS; results were similar for LSS. However, DM/Metformin was associated with inferior OS (HR = 2·17; 95% CI 1·19–3·95) compared to No DM/No metformin. In conclusion, we found no evidence that metformin use was associated with improved outcomes in newly diagnosed DLBCL and FL.