Metformin in Conjunction With Stereotactic Radiotherapy for Early-stage Non-small Cell Lung Cancer: Long-term Results of a Prospective Phase II Clinical Trial.

BACKGROUND/AIM: Non-small cell lung cancer (NSCLC) is increasingly detected in early stages and there is interest in improving outcomes with stereotactic body radiotherapy (SBRT). As metformin affects NSCLC signaling pathways, it might alter the metabolism of NSCLC treated with SBRT. This study investigated the long-term outcomes of a phase II clinical trial evaluating metformin in conjunction with SBRT for early-stage NSCLC. PATIENTS AND METHODS: The trial evaluated patients with American Joint Commission on Cancer (AJCC) 7th edition Stage I-II, cT1-T2N0M0 NSCLC who were randomized 6:1 to receive metformin versus placebo in conjunction with SBRT. The outcomes analyzed included local failure (LF), progression-free survival (PFS), overall survival (OS), and Common Terminology Criteria for Adverse Events (CTCAE) version 4 toxicities. RESULTS: There were 14 patients randomized to the metformin arm and one to the placebo. Median follow-up was four years. In the metformin group, the median PFS was 4.65 years [95% confidence interval (CI)=0.31-5.93] and median survival was 4.97 years (95%CI=3.05-4.61). Five year PFS was 27.8% (95%CI=5.3-57.3%) and OS was 46.0% (95%CI=16.0-71.9%). The one patient randomized to placebo was alive and without progression at five years. There were no LFs in the primary SBRT treatment volumes and no CTCAE version 4 Grade ≥3 adverse events. CONCLUSION: Outcomes of SBRT and metformin for early-stage NSCLC were similar to historic controls. These findings along with the results of the NRG-LU001 and OCOG randomized trials do not support the therapeutic use of metformin for NSCLC.

The Impact of Social Comparison via Social Media on Maternal Mental Health, within the Context of the Intensive Mothering Ideology: A Scoping Review of the Literature.

Social media platforms communicate narratives of individuals, specifically the narrative of motherhood. The ascendant mothering narrative in Western society is Intensive Mothering Ideology (IMI). These ideals, norms, and practices set unattainable standards. Highly romanticized versions of motherhood portrayed on social media tend to stimulate social comparisons among women potentially impacting their well-being. This scoping review seeks to examine the literature that identifies the impact of social comparison via social media on maternal mental health, within the context of IMI. The methodology by Arksey and O'Malley guided the approach to creating this scoping review. Systematic searches of articles published within the previous 10 years were conducted in Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO. Searches aimed to capture concepts regarding social media as a medium for social comparison, and transmission of intensive mothering ideologies ultimately impacting maternal mental health. Articles were screened at the title and abstract level first, followed by application of inclusion and exclusion criteria. Nine articles were selected for inclusion in this scoping review. The studies were published in seven peer-reviewed journals, from four different countries with most originating from the United States. Results revealed that making social comparisons after exposure to intensive mothering ideas negatively impacted maternal well-being. Within the context of the Social Comparison Theory (SCT), maternal characteristics like self-esteem and maternal comparison orientation (MCO) seem to mediate the impact that social media has on maternal mental health. Social media communicates highly idealized motherhood mores, and critical analyses should focus on how mothers use social media.