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2019年二甲双胍抗肿瘤作用临床研究进展
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20世纪初，糖尿病专家报道了一个不寻常的现象，采用二甲双胍治疗的糖尿病患者具有更低的肿瘤发生率；一系列流行病学研究证实二甲双胍使用者的肿瘤发生率可能显著下降。随后几项针对非糖尿病肿瘤患者的研究同样获得了鼓舞人心的证据，引发了研究者对二甲双胍抗肿瘤作用的广泛兴趣。本文将着重分析至今已获得的二甲双胍抗肿瘤临床证据，以及目前最新的临床研究焦点和方向。
二甲双胍抗肿瘤临床试验进展
图1 二甲双胍临床试验时间及适应症分布
数据来源： ClinicalTrials.gov，火石创造
表1 二甲双胍抗肿瘤的临床试验证据
资料来源：参考文献[1]
二甲双胍联合治疗策略的研究进展
1
二甲双胍与放化疗联合
表2 二甲双胍联合化疗抗肿瘤的临床试验证据
图2 非小细胞肺癌中二甲双胍联合治疗显著延长患者生存期
2
二甲双胍与靶向药物联合
表3 二甲双胍联合靶向治疗抗肿瘤的临床试验证据
数据来源：参考文献[9]
而在肺腺癌患者中[11]，二甲双胍与酪氨酸激酶抑制剂埃罗替尼、阿伐替尼、吉非替尼联用后，显著提高了患者中位无病生存期和中位生存期。
图4 肺腺癌患者进行二甲双胍联用TKIs显著提高中位无病生存期和中位生存期
3
二甲双胍与免疫治疗联合
表4 已登记二甲双胍联合免疫治疗抗肿瘤的临床试验
二甲双胍肿瘤预防的临床证据
小 结
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[3]Peng M, Darko K O, Tao T, et al. Combination of metformin withchemotherapeutic drugs via different molecular mechanisms[J]. Cancer TreatmentReviews, 2017.
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作者 | 钱恒
责编 | 老姜
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