Translational lung cancer research · 2025
Effect of type 2 diabetes mellitus on systemic treatment for advanced non-small cell lung cancer.
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Kato Yasuhiro, Kuramochi Eri, Yamaguchi Rei, Mikami Erika, Shinbu Kaoruko, Aoyama Jyunichi, Kobayashi Shunsuke, Okajima Fumitaka, Seike Masahiro, Okano Tetsuya
Аннотация
BACKGROUND: The effect of type 2 diabetes mellitus (T2DM) on treatments for advanced non-small cell lung cancer (NSCLC) remains unelucidated. We aimed to assess the effect of T2DM on the treatment for advanced NSCLC.
METHODS: We retrospectively investigated clinicopathological character, treatment effect, and adverse events (AEs) in advanced NSCLC patients started on systemic treatment at Nippon Medical School Chiba-Hokusoh Hospital from 2018 to 2024.
RESULTS: The numbers of T2DM and non-T2DM patients among those undergoing immune checkpoint inhibitor (ICI) therapy, molecular targeted therapy (MTT), and cytotoxic chemotherapy (CTT) were 37 and 78, 30 and 86, 9 and 17, respectively. The overall survival (OS) of patients complicated T2DM was significantly worse in total (19.3 vs. 34.5 months, P=0.001), the ICI (11.5 vs. 34.2 months, P=0.005) and the MTT cohort (27.4 vs. 43.4 months, P=0.03). Median progression-free survival (PFS) was significantly poor for T2DM patients in the ICI cohort (5.7 vs. 12.5 months, P=0.04). However, a significant difference was not found for the MTT cohort (13.3 vs. 12.7 months, P=0.91). There were no significant differences in AEs in either cohort. Hemoglobin A1c (HbA1c) was significantly higher in patients with derived neutrophil lymphocyte ratio (dNLR) ≥3. The PFS in T2DM patients in the ICI cohort was investigated with regard to clinicopathological factors and T2DM treatments. Specialist consultation was identified as a factor that improved PFS of ICI.
CONCLUSIONS: Our research suggests that T2DM is an independent poor prognostic factor in advanced NSCLC and affects ICI treatment.
METHODS: We retrospectively investigated clinicopathological character, treatment effect, and adverse events (AEs) in advanced NSCLC patients started on systemic treatment at Nippon Medical School Chiba-Hokusoh Hospital from 2018 to 2024.
RESULTS: The numbers of T2DM and non-T2DM patients among those undergoing immune checkpoint inhibitor (ICI) therapy, molecular targeted therapy (MTT), and cytotoxic chemotherapy (CTT) were 37 and 78, 30 and 86, 9 and 17, respectively. The overall survival (OS) of patients complicated T2DM was significantly worse in total (19.3 vs. 34.5 months, P=0.001), the ICI (11.5 vs. 34.2 months, P=0.005) and the MTT cohort (27.4 vs. 43.4 months, P=0.03). Median progression-free survival (PFS) was significantly poor for T2DM patients in the ICI cohort (5.7 vs. 12.5 months, P=0.04). However, a significant difference was not found for the MTT cohort (13.3 vs. 12.7 months, P=0.91). There were no significant differences in AEs in either cohort. Hemoglobin A1c (HbA1c) was significantly higher in patients with derived neutrophil lymphocyte ratio (dNLR) ≥3. The PFS in T2DM patients in the ICI cohort was investigated with regard to clinicopathological factors and T2DM treatments. Specialist consultation was identified as a factor that improved PFS of ICI.
CONCLUSIONS: Our research suggests that T2DM is an independent poor prognostic factor in advanced NSCLC and affects ICI treatment.