Meta-analysis Of The Effects Of Metformin On The Survival Of Pancreatic Cancer Patients

Purpose: To analysis the association between metformin and survival outcomes of pancreatic cancer patients.Methods: We had a systematic search of Pubmed、EMbase、Web of science、Cochrane、CBM、CNKI to identified the studies about the association between metformin and survival outcomes of pancreatic cancer patients,the studies were reported between the database began and February 28,2020.All studies were assessed by the Newcastle-Ottawa Scole(NOS).We pooled the hazard ratios(HRs)and 95% confidence intervals(95% CIs)from all eligible studies and calculated it by STATA 15.1.Results: A total of 15 studies were eligible,37,993 pancreatic cancer patients were included,comprising 13,369 patients who had received metformin and24624 patients who had not,the meta-analysis showed that metformin use is associated with better overall survival of patients with pancreatic cancer(HR=0.89;95%CI=0.82～0.96;P=0.002).It showed the same result in subgroup analysis of resectable pancreatic cancer patients(HR=0.79;95% CI=0.70～0.89,P<0.001).However,we can not find the survival benefit in patients with advanced pancreatic cancer(HR=1.08,95%CI=0.90～1.29,P=0.425).In the other subgroup,we also observed the same association in the group of Asian countries(HR=0.70,95% CI=0.60～0.81,P<0.001),while the diffrent result in European countries.In the subgroup of diabetes and no indication of diabetes,The results support that the use of metformin can improve the overall survival of patients with pancreatic cancer with concurrent diabetes.Conclusion: Metformin can improve the overall survival of patients with pancreatic cancer.We can observed the same association in the Asian patients,and metformin use is associated with better survival of patients with diabetes and resectable pancreatic cancer.