Metformin for the chemoprophylaxis of cancer: an update systematic review about the role of metformin in cancer prevention.

ABSTRACT

Objective: Metformin has been evaluated as a possible molecule capable of preventing cancer. We performed a systematic review on this topic in 2014. However, since then, a plethora of studies has been conducted. Therefore we decided to undertake an updated systematic review. Methods: Systematic search in Medline from March 1^st 2014 to May 16 2017, using the medical subject headings (MeSH descriptors) neoplasms, cancer and metformin, limiting the search to humans. Two independent investigators collected information. Results: 1428 potentially eligible articles were identified and 74 were eligible. Most studies showed conflicting results, with the majority being retrospective. However, a randomized placebo-controlled trial demonstrated that metformin reduced the incidence of colorectal polyps and adenomas. Conclusion: Except for colorectal cancer secondary prevention, current evidence does not support the use of metformin as a chemoprophylaxis agent in solid tumors. Controlled trials are necessary to prove the role of metformin on cancer prevention.

RESUMO

Objetivo: A metformina tem sido avaliada como uma possível molécula capaz de prevenir o câncer. Realizamos uma revisão sistemática sobre este tema em 2014. No entanto, desde então, uma infinidade de estudos foram realizados. Portanto, decidimos realizar uma revisão sistemática atualizada. Métodos: Pesquisa sistemática no Medline no período de 1o março de 2014 a 16 de maio de 2017, utilizando o Medical Subject Heading (MeSH descritores), neoplasias, câncer e metformina, limitando a busca por seres humanos. Dois investigadores independentes coletaram informações. Resultados: 1.428 artigos potencialmente elegíveis foram identificados e 74 foram elegíveis. A maioria dos estudos mostrou resultados conflitantes, sendo a maioria retrospectiva. No entanto, um estudo randomizado controlado por placebo demonstrou que a metformina reduziu a incidência de pólipos colorretais e adenomas. Conclusão: Com exceção da prevenção secundária ao câncer colorretal, evidências atuais não apoiam o uso de metformina como quimioprofilaxia em tumores sólidos. Estudos controlados são necessários para comprovar o papel da metformina na prevenção do câncer.

Keywords:

Metformin - Chemoprevention - Review

Palavras-chave:

Metformina - Quimioprevenção - Revisão

AUTHOR'S CONTRIBUTION

Mirella Nardo: Collection and assembly of data, Conception and design, Data analysis and interpretation, Final approval of manuscript, Manuscript writing.

Manoel Carlos Leonardi de Azevedo Souza: Collection and assembly of data, Data analysis and interpretation, Final approval of manuscript, Manuscript writing.

Renata Colombo Bonadio: Collection and assembly of data, Data analysis and interpretation, Final approval of manuscript, Manuscript writing.

Rachel P Riechelmann: Conception and design, Final approval of manuscript.

Publikationsverlauf

Eingereicht: 07. März 2019

Angenommen: 21. Juli 2019

Artikel online veröffentlicht:
06. August 2020

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