Diabetes drug appears to fight lung cancer — but only in overweight or obese patients

Nov. 26, 2024
Retrospective study led by Roswell Park’s Dr. Sai Yendamuri provides long-sought evidence.

A widely accessible drug commonly used to control blood glucose levels in diabetic patients has the potential to strengthen the effects of immunotherapy and improve recurrence-free survival in people with lung cancer who are overweight or obese, according to a recently published article in the Journal of the National Cancer Institute. 

Sai Yendamuri, MD, MBA, FACS, Chief Strategy Officer and Chair of Thoracic Surgery at Roswell Park Comprehensive Cancer Center, led the retrospective study as co-senior author. 

Over the past 20 years, researchers have seen evidence suggesting that metformin might slow cancer progression, but the results of clinical trials have largely failed to confirm the connection. Based on prior findings, Dr. Yendamuri and his colleagues from Roswell Park hypothesized that the anticancer benefits of the drug might be experienced in a specific group of lung cancer patients — those who are overweight or obese. They further suspected that strong evidence of these effects may have been obscured in past clinical trials that included normal-weight patients. 

To test that theory, the team looked at data from two groups of patients who had non-small cell lung cancer (NSCLC). One group included 511 patients with a body mass index (BMI) of 25 or higher, considered overweight/obese, and 232 with a BMI of less than 25, not considered overweight — all of whom underwent surgery. Data from a second group were used to evaluate the drug’s effect on progression-free survival in 284 overweight vs. 184 non-overweight patients with NSCLC who received a type of immunotherapy called an immune checkpoint inhibitor. Additionally, the team documented metformin’s effects on tumor progression, antitumor immunity and response to immune checkpoint inhibitors in the lab in preclinical lung cancer models. 

Based on their clinical and preclinical observations, Drs. Yendamuri and Joseph Barbi designed a phase 2 clinical trial(NCT04931017) to evaluate the drug’s potential for preventing lung cancer in overweight or obese people at high risk for the disease. Roswell Park is one of only three sites in the U.S and Canada to offer the trial, which is funded by the National Cancer Institute. 

Roswell Park Comprehensive Cancer Center release on Newswise

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