Introduction/Background Literature evidence demonstrated that the combination of metformin with other drugs, such as Poly (ADP-Ribose) Polymerase inhibitor (PARPi), has strong cytotoxic effects in ovarian cancer (OC) cells. However, these data come from preclinical studies. Thus, it is crucial to evaluate the role of metformin during PARPi maintenance in OC patients in clinical practice.
Methodology Data of patients affected by newly diagnosed OC who received metformin during the maintenance with PARPi, treated at our center from 2018 to 2022 were collected (Met Group). These were compared with a historical series of patients without metformin taking due to the absence of glucose metabolic disorder, with clinical and pathological features comparable (No-Met Group).
Results 17 OC patients in contextual treatment with metformin and PARPi and 17 patients without metformin were identified and compared. The characteristics of patients and disease at diagnosis were homogeneous regardless of the metformin intake. The median age of OC diagnosis was 62 years. The most frequent histotype was high-grade serous (97.1%) with FIGO stage IIIC (76.5%). The analyzed patient cohorts did not differ in terms of treatment: most of the patients underwent standard chemotherapy (3weekly carboplatin and paclitaxel) (91.1%) and interval debulking surgery (64.7%) with no residual tumor (94.1%).
After a median follow-up of 21 months, recurrences were more frequent in No-Met Group (58.8%) compared with Met Group (35.3%) (p 0.15).
There was a trend of improvement in median Progression-Free Survival (PFS) in patients who took metformin compared with those who did not, although not statistically significant (Median PFS: Met Group Not Reached vs No-Met Group 21 months, p 0.32 figure 1).
Conclusion A trend of survival improvement in patients treated with PARPi and metformin was detected. Our results might be considered hypothesis-generating research, justifying wider and prospective studies.
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