Metformin May Improve the Prognosis of Patients with Pancreatic Cancer

  • Zhang, Jia-Wei (The Department of Oncology, Nanjing Medical University Affiliated Wuxi Second Hospital) ;
  • Sun, Qing (The Department of Oncology, Nanjing Medical University Affiliated Wuxi Second Hospital)
  • Published : 2015.05.18


Background: Pancreatic cancer risk is increased in patients with type 2 diabetes, while being reduced by metformin treatment. However, it is unclear whether metformin could be associated with clinical outcomes of patients with pancreatic cancer and concurrent type 2 diabetes. Materials and Methods: A pooled analysis of 4 publications including 1,429 patients was performed to investigate the association of metformin and overall survival(OS) in patients with pancreatic cancer and concurrent type 2 diabetes. Results: A borderline significant relative survival benefit was found in metformin treated patients compared with non-metformin treated patients (hazard ratio 0.80; 95% CI: 0.62-1.03). Conclusions: These results suggest that further investigation is warranted of whether metformin may benefit the survival of patients with pancreatic cancer and concurrent type 2 diabetes.


Pancreatic cancer;metformin;survival;prognosis


  1. Kim SH, Kim MH, Kang B, Ahn JB, Choi HJ (2014).Metformin use is associated with improved survival in diabetic pancreatic cancer patients. Ann Oncol, 25, iv238.
  2. Lee MS, Hsu CC, Wahlqvist ML, et al (2011). Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. BMC Cancer, 11, 20.
  3. Li D, Yeung SC, Hassan MM, Konopleva M, Abbruzzese JL (2009). Antidiabetic therapies affect risk of pancreatic cancer. Gastroenterology, 137, 482-8.
  4. Nakai Y, Isayama H, Sasaki T, et al (2013). Clinical outcomes of chemotherapy for diabetic and nondiabetic patients with pancreatic cancer better prognosis with statin use in diabetic Patients. Pancreas, 42, 202-8.
  5. Rozengurt E, Sinnett-Smith J, Kisfalvi K (2010). Crosstalk between insulin/insulin-like growth factor-1 receptors and G protein-coupled receptor signaling systems: a novel target for the antidiabetic drug metformin in pancreatic cancer. Clin Cancer Res, 16, 2505-11.
  6. Sadeghi N, Abbruzzese JL, Yeung S-JJ, Hassan M, Li D (2012). Metformin use is associated with better survival of diabetic patients with pancreatic cancer. Clin Cancer Res, 18, 2905-912.
  7. Shen B, Zheng MQ, Lu JW, et al (2013). CXCL12-CXCR4 promotes proliferation and invasion of pancreatic cancer cells. Asian Pac J Cancer Prev, 14, 5403-8.
  8. Shu J, Li CG, Liu YC, Yan XC, et al (2012). Comparison of serum tumor associated material (TAM) with conventional biomarkers in cancerpatients. Asian Pac J Cancer Prev, 13, 2399-403.
  9. Sorin Ioacara, Cristian Guja, Constantin Ionescu-Tirgoviste, Simona Fica, Michael Roden (2014). Cancer specific mortality in insulin-treated type 2 diabetes patients. PLoS One, 9, 93132.
  10. Tong GX, Geng QQ, Chai J, et al (2014). Association between pancreatitis and subsequent risk of pancreatic cancer: a systematic review of epidemiological studies. Asian Pac J Cancer Prev, 15, 5029-34.
  11. Wilmink J, Kordes S, Zwinderman K, et al (2014). A phase II randomized, placebo controlled study to evaluate the efficacy of the combination of gemcitabine, erlotinib, and metformin in patients with locally advanced or metastatic pancreatic cancer. J Clin Oncol, 32, 4021.
  12. Witkowski ER, Ragulin-Coyne E, Chau Z, et al (2012). Effects of metformin on pancreatic cancer survival among medicare beneficiaries. J Clin Oncol, 30, 14691.
  13. Esbah O Eren, T Helvaci, K Guler, et al (2014). The effect of metformin use on prognosis in pancreatic cancer. Acta Medica Mediterranea, 30, 465-471
  14. Hwang AL, Haynes K, Hwang WT, Yang YX (2013). Metformin and survival in pancreatic cancer a retrospective cohort. Pancreas, 42, 1054-9.
  15. Bodmer M, Becker C, Meier C, Jick SS, Meier CR (2012). Use of antidiabetic agents and the risk of pancreatic cancer: a case-control analysis. Am J Gastroenterol, 107, 620-6.
  16. Chen WQ, Liang D, Zhang SW, et al (2013). Pancreatic cancer incidence and mortality patterns in China, 2009. Asian Pac J Cancer Prev, 4, 7321-4.
  17. Chun-Chih Chiu, Chin-Chou Huang, Yu-Chun Chen, et al (2013). Increased risk of gastrointestinal malignancy in patients with diabetes mellitus and correlations with anti-diabetes drugs: A nationwide population-based study in Taiwan. Intern Med, 52, 939-46.
  18. Currie CJ, Poole CD, Gale EA (2009). The influence of glucose-lowering therapies on cancer risk in type 2 diabetes. Diabetologia, 52, 1766-77.
  19. Do-Youn Oh, Younak Choi, Tae-Yong Kim, et al (2013). The impact of diabetes mellitus and metformin on survival of patients with advanced pancreatic cancer receiving chemotherapy. J Clin Oncol, 31, 4044
  20. Esbah O, Oksuzoglu B, Eren T, et al (2013). Metformin in diabetic pancreatic cancer patients: benefit or not-multicenter experience. J Clin Oncol, 31, 15110.

Cited by

  1. Evaluation of Effects of Metformin in Primary Ovarian Cancer Cells vol.16, pp.16, 2015,
  2. Inhibitory effect of metformin combined with gemcitabine on pancreatic cancer cells in vitro and in vivo vol.14, pp.4, 2016,
  3. Metformin inhibits SUV39H1-mediated migration of prostate cancer cells vol.6, pp.5, 2017,
  4. The effect of metformin on survival of patients with pancreatic cancer: a meta-analysis vol.7, pp.1, 2017,