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Concurrent Nivolumab and Metformin in Diabetic Cancer Patients: Is It Safe and More Active?
Ciccarese, Chiara; Iacovelli, Roberto; Buti, Sebastiano; Primi, Francesca; Astore, Serena; Massari, Francesco; Ferrara, Miriam Grazia; Palermo, Giuseppe; Foschi, Nazario; Iacovelli, Valerio; Rossi, Ernesto; Schinzari, Giovanni; Bove, Pierluigi; Bassi, Pierfrancesco; Bria, Emilio; Tortora, Giampaolo.
Affiliation
  • Ciccarese C; Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Iacovelli R; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Buti S; Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; roberto.iacovelli@policlinicogemelli.it.
  • Primi F; Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
  • Astore S; Department of Medical Oncology, Belcolle Hospital of Viterbo, Viterbo, Italy.
  • Massari F; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Ferrara MG; Department of Medical Oncology, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
  • Palermo G; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Foschi N; Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Iacovelli V; Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Rossi E; Department of Urology, San Carlo di Nancy Hospital, Rome, Italy.
  • Schinzari G; Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Bove P; Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Bassi P; Università Cattolica del Sacro Cuore, Rome, Italy.
  • Bria E; Department of Urology, San Carlo di Nancy Hospital, Rome, Italy.
  • Tortora G; Department of Medical Oncology, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Anticancer Res ; 42(3): 1487-1493, 2022 Mar.
Article in En | MEDLINE | ID: mdl-35220243
BACKGROUND/AIM: Recent evidence suggests potential synergistic antitumor effects of the combination of programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors with the oral hypoglycemic agent metformin. The aim of this study was to investigate the safety and activity of metformin combined with nivolumab in diabetic cancer patients. PATIENTS AND METHODS: Patients with advanced melanoma, renal cell carcinoma or lung cancer receiving nivolumab with concurrent diabetes treated with metformin were retrospectively collected. The primary endpoint was the safety of nivolumab plus metformin combination. RESULTS: We collected 40 patients with solid tumors who received metformin for concomitant diabetes and nivolumab as anticancer therapy in four Italian Hospitals. The concomitant use of nivolumab and metformin was well tolerated; adverse events (AEs) of any grade occurred in 75% of patients (mainly fatigue, pruritus, rash, and asthenia). Grade 3 AEs occurred only in 20% of cases; no grade 4 AEs were observed. A statistically significant correlation was found between higher doses of metformin (>1,000 mg daily) and longer progression-free survival (p=0.021), overall survival (p=0.037) and higher overall response rate. CONCLUSION: The combination of nivolumab and metformin was safe and might have an antitumor activity, supporting further investigations on the synergistic antitumor effect of this combination.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / B7-H1 Antigen / Nivolumab / Immune Checkpoint Inhibitors / Hypoglycemic Agents / Metformin / Neoplasms Type of study: Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: En Journal: Anticancer Res Year: 2022 Document type: Article Affiliation country: Italy Country of publication: Greece

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / B7-H1 Antigen / Nivolumab / Immune Checkpoint Inhibitors / Hypoglycemic Agents / Metformin / Neoplasms Type of study: Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: En Journal: Anticancer Res Year: 2022 Document type: Article Affiliation country: Italy Country of publication: Greece