2024 World Conference on Lung Cancer (WCLC) - Posters-P2.11A.20 Metformin Enhances Immune Checkpoint Inhibitor Response in Overweight Lung Cancer Patients: A Retrospective Cohort Study

P2.11A.20 Metformin Enhances Immune Checkpoint Inhibitor Response in Overweight Lung Cancer Patients: A Retrospective Cohort Study

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This study explored the effects of metformin, a medication commonly used for type 2 diabetes, on enhancing the response to immune checkpoint inhibitors (ICIs) among overweight lung cancer patients. Previous preclinical studies suggested metformin's potential anti-cancer effects, but clinical trials showed inconsistent results, limiting its integration into cancer treatment strategies. The objective was to assess if metformin's effectiveness differed based on patients' body mass index (BMI).<br /><br />The retrospective cohort study involved 480 non-small cell lung cancer (NSCLC) patients treated with at least three ICI doses between 2015 and 2023. Patients were divided into two groups based on BMI: overweight (BMI ≥ 25) and non-overweight (BMI < 25). Data on demographics, smoking status, histology, and metformin use history were collected, and patients' responses to treatment were categorized as either non-progressors or progressors.<br /><br />The study found a significant association between metformin use and improved progression-free survival (PFS) rates. While univariate analysis highlighted female sex and metformin use as associated with increased risk of progression, multivariable analysis revealed significantly improved PFS among metformin users after adjusting for sex, smoking status, histology, and first-line regimen.<br /><br />These findings emphasize the need for further research through large-scale, multicenter prospective studies to confirm metformin's efficacy in overweight lung cancer patients, particularly those undergoing checkpoint blockade therapy. Additionally, understanding the molecular mechanisms driving metformin's BMI-dependent effects is crucial. The study posits that BMI could serve as a predictive marker to enhance patient selection for treatment with metformin, optimizing outcomes in lung cancer therapy.

Asset Subtitle

Akhil Pachimatla

Meta Tag

Speaker Akhil Pachimatla

Topic Metastatic NSCLC – Immunotherapy

Keywords

metformin

type 2 diabetes

immune checkpoint inhibitors

overweight lung cancer

non-small cell lung cancer

progression-free survival

body mass index

retrospective cohort study

checkpoint blockade therapy

predictive marker