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Antihyperglycaemic therapies and cancer risk

Stefan Z Lutz1, Harald Staiger2, Andreas Fritsche3

  • 1Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany German Centre for Diabetes Research (DZD), Tübingen, Germany.

Diabetes & Vascular Disease Research
|September 19, 2014
PubMed
Abstract

Insights

Metformin may protect against certain cancers, while other antidiabetic drugs like sulphonylureas, incretin-based therapies, SGLT2 inhibitors, and pioglitazone may increase cancer risk. Further research is needed to confirm these findings.

Area of Science:

  • Endocrinology
  • Oncology
  • Pharmacology

Background:

  • Antihyperglycemic medications are widely used for diabetes management.
  • Concerns exist regarding the potential impact of these drugs on cancer development and progression.
  • Understanding these effects is crucial for patient safety and treatment optimization.

Purpose of the Study:

  • To review and discuss current evidence on the mitogenic or antimitogenic effects of major antihyperglycemic drug classes.
  • To evaluate the association between antidiabetic medications and malignancies.

Main Methods:

  • Comprehensive literature review of current studies.
  • Analysis of clinical data on antidiabetic drug use and cancer incidence.
  • Evaluation of meta-analyses and controversial findings.

Main Results:

  • Metformin demonstrates protective effects against several site-specific cancers in monotherapy and combination treatments.
  • Concerns regarding increased cancer risk are noted for sulfonylureas, incretin-based therapies (pancreatic, thyroid cancers), SGLT2 inhibitors, and pioglitazone (bladder cancer).
  • Evidence for increased cancer risk with insulin glargine is controversial; alpha-glucosidase inhibitors and glinides show neutral or limited data.

Conclusions:

  • Several antihyperglycemic drug classes may possess mitogenic or tumor-promoting potential, though mechanisms are unclear.
  • Large-scale, randomized clinical trials with long follow-up are essential to definitively assess cancer risks associated with these medications.
Keywords:
Diabetesantidiabetic therapyinsulinmalignancytumour growth

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