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The effects of metformin on ovarian cancer: a systematic review
Piyemeth Dilokthornsakul1, Nathorn Chaiyakunapruk, Wichai Termrungruanglert
1*Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; †School of Population Health, University of Queensland, Brisbane, Australia; ‡School of Pharmacy, University of Wisconsin-Madison, Madison, WI; §Discipline of Pharmacy, Monash University Sunway Campus, Malaysia; and ∥Faculty of Medicine, Chulalongkorn University, Bangkok; ¶Faculty of Public Health, Naresuan University, Phitsanulok; and #School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.
Objective:
The potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aim to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer.
Methods:
We performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included "metformin" AND ("ovarian cancer" OR "ovary tumor"). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model.
Results:
Of 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16-1.99).
Conclusions:
Our findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.
Insights
Metformin shows potential therapeutic effects for ovarian cancer, possibly improving survival and preventing occurrence. Further clinical trials are needed to confirm these findings in ovarian cancer patients.
Area of Science:
- Oncology
- Pharmacology
- Epidemiology
Background:
- Metformin is being investigated for its potential anti-cancer effects across various malignancies.
- Evidence regarding metformin's impact on ovarian cancer is limited and requires further investigation.
Purpose of the Study:
- To systematically review and meta-analyze existing evidence on the therapeutic effects of metformin in ovarian cancer.
- To summarize findings on metformin's impact on ovarian cancer survival and prevention.
Main Methods:
- Systematic literature search of PubMed and EMBASE databases up to December 2012.
- Inclusion of human studies evaluating metformin's effects on ovarian cancer, with independent review by two authors.
- Data pooling using a random-effects model for meta-analysis.
Main Results:
- Analysis included 3 observational studies and 1 report of 2 randomized controlled trials.
- Metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients.
- Meta-analysis suggested metformin may decrease ovarian cancer occurrence in diabetic patients (OR 0.57).
Conclusions:
- Metformin demonstrates potential therapeutic benefits for ovarian cancer survival and prevention.
- The current evidence predominantly relies on observational studies.
- Well-designed clinical trials are essential to validate metformin's efficacy in ovarian cancer.
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