Effect of metformin and statin use on survival in pancreatic cancer patients: A systematic literature review and meta-analysis

E. Jian-Yu, Judith M. Graber, Shou En Lu, Yong Lin, Grace Lu-Yao, Xiang Lin Tan

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations

Abstract

Background and Objective: Current epidemiological studies report conflicting results for the effect of statin or metformin on pancreatic cancer overall survival. This literature review and meta-analysis summarize the studies reporting an association between statin or metformin use and overall survival of pancreatic cancer patients. Methods: We systematically searched for studies about the association between statin or metformin use and pancreatic cancer overall survival in electronic databases (PubMed, ISI Web of Science, MEDLINE, Cochrane, Scopus, Google Scholar). A meta-analysis based on hazard ratios (HRs) and 95% confidence intervals (CIs) was performed using random effect models. Heterogeneity between the studies was examined using I2 statistics, and sensitivity analyses were conducted to assess the robustness of the findings. Results: Of 116 statin-related articles identified, 6 retrospective cohort studies representing 12,057 patients were included. There was significant heterogeneity between studies. Statin use was associated with improved survival among pancreatic cancer patients (meta-HR = 0.75; 95% CI: 0.59, 0.90; P < 0.001). Of 311 metformin-related articles, 8 retrospective cohort studies and 2 randomized clinical trials, representing 3,042 patients were identified. Metformin use was associated with better overall survival among pancreatic cancer patients (meta-HR = 0.79; 95% CI: 0.70, 0.92, P < 0.001), and significant heterogeneity was observed between studies. Conclusion: Our findings suggest that the improved survival time of pancreatic cancer patients are associated with statin or metformin use. Due to the multiple sources of heterogeneity of the original studies, these findings should be considered cautiously, and confirmed with larger prospective individual-level studies.

Original languageAmerican English
Pages (from-to)2595-2607
Number of pages13
JournalCurrent Medicinal Chemistry
Volume25
Issue number22
DOIs
StatePublished - 2018

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Medicine
  • Pharmacology
  • Drug Discovery
  • Organic Chemistry

Keywords

  • Cancer drug
  • Meta-analysis
  • Metformin
  • Overall survival
  • Pancreatic cancer
  • Statin

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