A study suggests that metformin, a common diabetes medication, may enhance immune responses in lung cancer patients with obesity, potentially improving treatment outcomes. This discovery has significant implications for future clinical trials.
Metformin, a drug typically used to manage blood sugar levels, shows promise in offering new treatment options for overweight individuals fighting lung cancer. Research indicates that metformin could enhance the effectiveness of immunotherapy and prolong recurrence-free survival in overweight lung cancer patients.
Joseph Barbi, assistant professor of oncology at Roswell Park’s Department of Immunology and co-senior author of the study, stated, “Our study suggests that metformin may improve the prognosis for overweight and obese lung cancer patients by counteracting the negative effects of these conditions on the body’s anti-tumor immune response.”
Metformin and Anti-Cancer Benefits
Scientists at Roswell Park Comprehensive Cancer Center in Buffalo, New York, theorized that the anti-cancer properties of metformin could be particularly impactful in overweight or obese lung cancer patients. Previous evidence spanning two decades has linked metformin to slowed cancer progression.
Past clinical trials often focused on patients of normal weight and did not conclusively demonstrate the anti-cancer effects of metformin. The researchers suggested that a predominantly normal-weight patient population might have obscured more robust evidence of the drug’s benefits in specific subgroups, such as overweight or obese individuals.
The second cohort focused on assessing the impact of metformin on progression-free survival in 284 overweight patients compared to 184 non-overweight patients receiving immunotherapy, a form of cancer treatment.
- Reduced Cancer Recurrence: Overweight individuals who underwent lung surgery saw a lower recurrence rate when taking metformin.
- Slowed Tumor Growth: Metformin slowed tumor growth in overweight mice by affecting the immune system.
- Improved Immunotherapy: Combining metformin with immunotherapy showed enhanced effectiveness in treating cancer in overweight mice and human patients.
Barbi explained, “Obesity can negatively impact the immune system, potentially hindering effective anti-tumor responses and leading to poor outcomes. Previous research has linked central obesity to aggressive disease and immune dysfunction in lung cancer patients and preclinical models.”
Mechanism of Action
Preclinical studies have demonstrated that metformin can inhibit tumor growth and reverse immune suppression caused by obesity. Combining metformin with an immune checkpoint inhibitor improved tumor growth control, particularly in obese patients.
Barbi elaborated, “In overweight or obese patients, metformin appears to rebalance immune-suppressive mechanisms with those that activate tumor-fighting processes.”
Implications for Future Clinical Trials
Barbi emphasized the importance of understanding the impact of excess weight and body fat on disease progression and immune function, especially as a growing number of lung cancer patients fall into the overweight or obese category. He highlighted the need for effective treatment strategies and the development of new therapies to address the evolving patient demographics.
While the study focused on lung cancer, Barbi suggested that metformin’s context-specific effects could potentially benefit other cancer types. Given the drug’s ability to enhance anti-tumor immune responses in obese lung cancer models, further research is warranted to explore its broader applicability.
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