scholarly journals Metformin is associated with survival benefit in pancreatic cancer patients with diabetes: a systematic review and meta-analysis

Oncotarget ◽  
2017 ◽  
Vol 8 (15) ◽  
pp. 25242-25250 ◽  
Author(s):  
Ping-Ting Zhou ◽  
Bo Li ◽  
Fu-Rao Liu ◽  
Mei-Chao Zhang ◽  
Qian Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Survival Benefit ◽  
Meta Analysis ◽  
Patients With Diabetes

scholarly journals Survival Benefit of Metformin Adjuvant Treatment For Pancreatic Cancer Patients: a Systematic Review and Meta-Analysis

2018 ◽  
Vol 49 (3) ◽  
pp. 837-847 ◽  
Author(s):  
Guoxing Wan ◽  
Xue Sun ◽  
Fang Li ◽  
Xuanbin Wang ◽  
Chen Li ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Survival Benefit ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Stage I ◽  
Metformin Therapy ◽  
Risk Of Death ◽  
Comprehensive Therapy

Background/Aims: Previous studies on the effect of metformin therapy on survival of pancreatic cancer patients obtained inconsistent findings. To reevaluate the prognostic value of metformin adjuvant treatment, a meta-analysis was carried out. Methods: Relevant articles addressing the association between metformin use and pancreatic cancer survival were electronically searched to identify eligible studies. Pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated to assess the strength of the association. Results: Totally, seventeen studies involving 36791 participants were included. Overall, metformin use was found to be significantly associated with a favorable OS (HR=0.88, 95% CI=0.80-0.97). Subgroup analyses by ethnicity showed a significantly reduced risk of death for metformin users compared with non-users in Asians (HR=0.74, 95% CI=0.58-0.94) but nonsignificant in Caucasians. When stratified by clinical stage, a remarkable reduction of mortality risk in patients at stage I-II treated with metformin (HR=0.76, 95% CI=0.68-0.86) was found as well as the group at stage I-IV (HR=0.88, 95% CI=0.79-0.99), but not in patients at stage III-IV. In the stratification analyses based on treatment strategy, metformin therapy was found to be associated with a better clinical outcome in patients receiving surgery or comprehensive therapy (HR=0.73, 95% CI=0.62-0.87; HR=0.88, 95% CI=0.79-0.97) but not chemotherapy. However, the overall analysis failed to show a significant association between metformin use and DFS (HR=1.54, 95% CI=0.94 -2.50) with only 2 studies enrolled. Conclusion: The current study has evidenced a significant association of metformin adjuvant treatment with the survival benefit for pancreatic cancer patients, suggesting a potentially available option for the treatment. Further investigation is needed.

Statins Use and Overall Survival in Pancreatic Cancer Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 152 (5) ◽  
pp. S277-S278
Author(s):  
Srikar R. Mapakshi ◽  
Jennifer R. Kramer ◽  
Kathryn E. Royse ◽  
Elizabeth Chiao ◽  
Jose M. Garcia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Meta Analysis

scholarly journals Primary Thromboprophylaxis in Ambulatory Pancreatic Cancer Patients Receiving Chemotherapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2028 ◽  
Author(s):  
Corinne Frere ◽  
Benjamin Crichi ◽  
Barbara Bournet ◽  
Cindy Canivet ◽  
Nassim Ait Abdallah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Phase Iii ◽  
Number Needed To Treat ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

Patients with pancreatic cancer (PC) carry the highest risk of venous thromboembolism (VTE) amongst all cancer patients. Appropriate use of primary thromboprophylaxis might significantly and safely reduce its burden. We performed a systematic review of published studies and meeting abstracts using MEDLINE and EMBASE through July 2020 to evaluate the efficacy and safety of primary thromboprophylaxis in ambulatory PC patients receiving chemotherapy. The Mantel–Haenszel random effect model was used to estimate the pooled event-based risk ratio (RR) and the pooled absolute risk difference (RD) with a 95% confidence interval (CI). Five randomized controlled studies with 1003 PC patients were included in this meta-analysis. Compared to placebo, thromboprophylaxis significantly decreased the risk of VTE (pooled RR 0.31, 95% CI 0.19–0.51, p < 0.00001, I2 = 8%; absolute RD −0.08, 95% CI −0.12–−0.05, p < 0.00001, I2 = 0%), with an estimated number needed to treat of 11.9 patients to prevent one VTE event. Similar reductions of VTE were observed in studies with parenteral (RR 0.30, 95% CI 0.17–0.53) versus oral anticoagulants (RR 0.37, 95% CI 0.14–0.99) and in studies using prophylactic doses of anticoagulants (RR 0.34, 95% CI 0.17–0.70) versus supra-prophylactic doses of anticoagulants (RR 0.27, 95% CI 0.08–0.90). The pooled RR for major bleeding was 1.08 (95% CI 0.47–2.52, p = 0.85, I2 = 0%) and the absolute RD was 0.00 (95% CI −0.02–0.03, p = 0.85, I2 = 0%). Evidence supports a net clinical benefit of thromboprophylaxis in ambulatory PC patients receiving chemotherapy. Adequately powered randomized phase III studies assessing the most effective anticoagulant and the optimal dose, schedule and duration of thromboprophylaxis to be used are warranted.

scholarly journals EUS-guided celiac plexus neurolysis for pain in pancreatic cancer patients – a meta-analysis and systematic review

2021 ◽  
Vol 11 (4) ◽  
pp. 536-542
Author(s):  
Abuzar A. Asif ◽  
Saqib K. Walayat ◽  
Matthew L. Bechtold ◽  
Vakya Revanur ◽  
Srinivas R. Puli
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Celiac Plexus

scholarly journals miRNA Predictors of Pancreatic Cancer Chemotherapeutic Response: A Systematic Review and Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 900 ◽  
Author(s):  
Madurantakam Royam ◽  
Ramesh ◽  
Shanker ◽  
Sabarimurugan ◽  
Kumarasamy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Publication Bias ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
P Value ◽  
Chemotherapy Response ◽  
Response To Chemotherapy ◽  
Incidence And Mortality

Background: pancreatic cancer (PC) has increasing incidence and mortality in developing countries, and drug resistance is a significant hindrance to the efficacy of successful treatment. The objective of this systematic review and meta-analysis was to evaluate the association between miRNAs and response to chemotherapy in pancreatic cancer patients. Methods: the systematic review and meta-analysis was based on articles collected from a thorough search of PubMed and Science Direct databases for publications spanning from January 2008 to December 2018. The articles were screened via a set of inclusion and exclusion criteria based on the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. Data was extracted, collated and tabulated in MS Excel for further synthesis. Hazard ratio (HR) was selected as the effect size metric to be pooled across studies for the meta-analysis, with the random effects model being applied. Subgroup analysis was also conducted, and the presence of publication bias in the selected studies was assessed. Publication bias of the included studies was quantified. Findings: of the 169 articles screened, 43 studies were included in our systematic review and 13 articles were included in the meta-analysis. Gemcitabine was observed to be the principal drug used in a majority of the studies. A total of 48 miRNAs have been studied, and 18 were observed to have possible contributions to chemoresistance, while 15 were observed to have possible contributions to chemosensitivity. 41 drug-related genetic pathways have been identified, through which the highlighted miRNA may be affecting chemosensitivity/resistance. The pooled HR value for overall survival was 1.603; (95% Confidence Interval (CI) 1.2–2.143; p-value: 0.01), with the subgroup analysis for miR-21 showing HR for resistance of 2.061; 95% CI 1.195–3.556; p-value: 0.09. Interpretation: our results highlight multiple miRNAs that have possible associations with modulation of chemotherapy response in pancreatic cancer patients. Further studies are needed to discover the molecular mechanisms underlying these associations before they can be suggested for use as biomarkers of response to chemotherapeutic interventions in pancreatic cancer.

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