KEY TAKEAWAYS
- The study aimed to assess metformin’s addition to R-CHOP in DLBCL, focusing on response rate, toxicity, PFS, and OS.
- The results revealed that adding metformin to standard R-CHOP may improve outcomes in DLBCL with acceptable safety.
Metformin has demonstrated antitumor activity across various cancers. In diffuse large B-cell lymphoma (DLBCL), combining metformin with front-line chemotherapy and immunotherapy has led to improved clinical outcomes.
Amira Hegazy and the team aimed to evaluate the impact of adding metformin to the standard R-CHOP regimen for DLBCL, focusing on response rate, toxicity, progression-free survival (PFS), and overall survival (OS).
This prospective phase 2 trial included 100 adult patients with histopathologically confirmed DLBCL, eligible for first-line R-CHOP treatment, a life expectancy of at least 6 months, and a performance status (PS) of 2 or lower. Patients were randomly assigned to receive either metformin plus R-CHOP or R-CHOP alone.
Each group comprised 50 patients. The metformin group had a higher proportion of females compared to the standard group (P=0.016). Nausea was significantly more common in the metformin group than in the standard group (P=0.008). The metformin group achieved higher complete remission rates at the end of treatment (92% vs. 74%; P=0.017), lower relapse/progression rates (10% vs. 36%; P=0.002), and reduced overall mortality (4% vs. 20%; P=0.014).
The mean disease-free survival (DFS) was 24.5 months for the metformin group compared to 20.2 months for the control group (P=0.023). The mean PFS was 25.91 months versus 19.81 months, and the mean OS was 27.39 months versus 23.8 months (P-values=0.002 and 0.013, respectively). Multivariate analysis indicated that metformin use was an independent prognostic factor for complete remission and reduced relapse.
The study concluded that adding metformin to standard R-CHOP could enhance clinical outcomes in patients with DLBCL while maintaining a tolerable safety profile.
No funding information was available.
Source: https://pubmed.ncbi.nlm.nih.gov/39068568/
Hegazy A, Ali MS, Mubarak NA, et al. (2024). “Metformin in Combination with Standard Therapy in Patients with Diffuse Large B-Cell Lymphoma: A Randomized Phase II Clinical Trial.” Asian Pac J Cancer Prev. 2024;25(7):2351-2359. Published 2024 Jul 1. doi:10.31557/APJCP.2024.25.7.2351
