The prevalence of secondary neoplasms in acromegalic patients : possible preventive and/or protective role of metformin
BACKGROUND: Acromegaly is a rare disease due to chronic growth hormone (GH) excess and the consequent increase in insulin-like growth factor-1 (IGF-1) levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. The association between hyperinsulinemia/impaired glucose tolerance and an increased risk of cancer has been clarified. Insulin has a mitogenic effect through its interaction with the IGF-1 receptor (IGF-1R) that also binds IGF-1. On the other hand, metformin, an anti-hyperglycemic drug that decreases serum levels of insulin and IGF-1, could have a protective role in the treatment of endocrine tumors.
METHODS: A retrospective, observational, multicenter study in 197 acromegalic patients, receiving/not receiving metformin, was performed to assess whether the prevalence of neoplasms might be correlated with insulin resistance and could eventually be modified by metformin treatment.
RESULTS: In general, the occurrence of secondary neoplasia among our patients was significantly (pV = 0.035) associated with a positive family history of malignancy and with disease duration; a trend towards significance was observed in patients aged > 50 years. Acromegalic subjects who had undergone surgery showed a lower probability of developing a malignant tumor, whereas a higher prevalence of malignancies was observed in obese patients. No significant statistical difference was found when comparing metformin-treated or -untreated subjects for the presence of a second tumor. More interestingly, a trend towards statistical significance (pV = 0.065) was demonstrated in the metformin-treated group for the onset of a benign neoplasm.
CONCLUSION: Metformin could act directly on tumor cell metabolism and may have an adjuvant role in benign lesion progression.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
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| Enthalten in: |
International journal of clinical oncology - 26(2021), 6 vom: 13. Juni, Seite 1015-1021 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Costa, Denise [VerfasserIn] |
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| Links: |
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| Themen: |
Acromegaly |
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| Anmerkungen: |
Date Revised 25.05.2021 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1007/s10147-021-01895-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM32270023X |
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| 100 | 1 | |a Costa, Denise |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The prevalence of secondary neoplasms in acromegalic patients |b possible preventive and/or protective role of metformin |
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| 500 | |a Date Revised 25.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND: Acromegaly is a rare disease due to chronic growth hormone (GH) excess and the consequent increase in insulin-like growth factor-1 (IGF-1) levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. The association between hyperinsulinemia/impaired glucose tolerance and an increased risk of cancer has been clarified. Insulin has a mitogenic effect through its interaction with the IGF-1 receptor (IGF-1R) that also binds IGF-1. On the other hand, metformin, an anti-hyperglycemic drug that decreases serum levels of insulin and IGF-1, could have a protective role in the treatment of endocrine tumors | ||
| 520 | |a METHODS: A retrospective, observational, multicenter study in 197 acromegalic patients, receiving/not receiving metformin, was performed to assess whether the prevalence of neoplasms might be correlated with insulin resistance and could eventually be modified by metformin treatment | ||
| 520 | |a RESULTS: In general, the occurrence of secondary neoplasia among our patients was significantly (pV = 0.035) associated with a positive family history of malignancy and with disease duration; a trend towards significance was observed in patients aged > 50 years. Acromegalic subjects who had undergone surgery showed a lower probability of developing a malignant tumor, whereas a higher prevalence of malignancies was observed in obese patients. No significant statistical difference was found when comparing metformin-treated or -untreated subjects for the presence of a second tumor. More interestingly, a trend towards statistical significance (pV = 0.065) was demonstrated in the metformin-treated group for the onset of a benign neoplasm | ||
| 520 | |a CONCLUSION: Metformin could act directly on tumor cell metabolism and may have an adjuvant role in benign lesion progression | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acromegaly | |
| 650 | 4 | |a Benign neoplasm | |
| 650 | 4 | |a Metformin | |
| 650 | 4 | |a Secondary tumor prevalence | |
| 700 | 1 | |a Ceccato, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Lauretta, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Mercuri, Valeria |e verfasserin |4 aut | |
| 700 | 1 | |a D'Amico, Tania |e verfasserin |4 aut | |
| 700 | 1 | |a De Vito, Corrado |e verfasserin |4 aut | |
| 700 | 1 | |a Scaroni, Carla |e verfasserin |4 aut | |
| 700 | 1 | |a Appetecchia, Marialuisa |e verfasserin |4 aut | |
| 700 | 1 | |a Gargiulo, Patrizia |e verfasserin |4 aut | |
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