Poor glycemic control might compromise the efficacy of chemotherapy in non-small cell lung cancer patients with diabetes mellitus.

Xianghua Zeng,Zhongyu Wang,Zhihua Gong,Haixia Long,Chengdu Sun,Bo Zhu,Jianan Cheng,Cheng Xu

doi:10.1002/cam4.2750

Xianghua Zeng, Zhongyu Wang + Show 6 more

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https://doi.org/10.1002/cam4.2750

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Abstract

BackgroundPrevious studies indicated that type 2 diabetes mellitus (T2DM) is related to an increased lung cancer risk, but its role in the prognosis of NSCLC remains conflicting. This study investigated the impact of blood glucose control on the outcomes in NSCLC patients with T2DM treated with platinum‐based doublets.MethodsClinicopathological and survival data from 191 T2DM patients with advanced NSCLC, who received platinum‐based chemotherapy, were retrospectively analyzed. Based on the blood glucose conditions during chemotherapy, patients were classified into poor (n = 84) and good control (n = 107) groups. Progression‐free survival (PFS) was assessed using the Kaplan‐Meier method.ResultsThe median PFS among patients with good glycemic control [197.0 (95% CI: 136.3‐257.7) days] was longer than that among those with poor control [132.0 (95% CI: 112.5‐151.5) days] (P = .0003). Further subgroup analysis of lung squamous carcinoma and adenocarcinoma patients showed that the median PFS of the good control group was also significantly longer than that of the poor control group [179.0 (95% CI: 78.4‐279.6) days vs 125.0 (95% CI: 110.9‐139.1) days, P = .0014; 197.0 (95% CI: 124.3‐269.7) days vs 154.0 (95% CI: 129.9‐178.1) days, P = .0359; respectively]. The incidence rates of side effects were similar among patients with good glycemic control and those with poor glycemic control (all P > .05).ConclusionsSatisfactory glycemic control during platinum‐based chemotherapy might provide a survival benefit to T2DM patients with NSCLC. Further studies are warranted to confirm our findings.

Highlights

Lung cancer has become one of the most common malignant tumors to threaten human health due to its high morbidity and mortality.[1,2] Non-small cell lung cancer (NSCLC) accounts for more than 85% of all lung cancer cases.[3]
The late diagnosis of NSCLC is widely recognized to be associated with worse survival, comorbidities, type 2 diabetes mellitus (T2DM), are another major risk factor affecting the prognosis of patients with NSCLC in clinical practice.[7-9]
Considering all the findings above, we conducted this retrospective study to investigate the impact of the blood glucose conditions of T2DM on Progression-free survival (PFS) in patients with unresectable and advanced NSCLC treated with platinum-based doublet chemotherapy

Summary

| INTRODUCTION

Lung cancer has become one of the most common malignant tumors to threaten human health due to its high morbidity and mortality.[1,2] Non-small cell lung cancer (NSCLC) accounts for more than 85% of all lung cancer cases.[3]. For advanced-stage patients without target gene mutations, platinum-based and two-drug chemotherapy regimens have long been the standard first-line treatment, which might lead to a median overall survival of less than 10 months.[6]. A large number of studies have been concerned with the prognostic significance of preexisting diabetes mellitus (DM) or the fasting blood glucose (FBG) level in patients with NSCLC, not the glycemic control conditions.[10,15,16]. Some studies have reported that preexisting DM was considered an independent inferior prognostic factor for overall survival and PFS, while others found that DM did not impact or even prolong lung cancer patients’ survival.[9,17-19]. Considering all the findings above, we conducted this retrospective study to investigate the impact of the blood glucose conditions of T2DM on PFS in patients with unresectable and advanced NSCLC treated with platinum-based doublet chemotherapy

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Findings

| DISCUSSION