| アブストラクト | Pemetrexed is a folate analog inhibitor for the treatment of non-small-cell lung cancer (NSCLC). Prophylactic supplementation with vitamin B(12) and folic acid reduces hematotoxicity associated with pemetrexed. Metformin, the antidiabetic agent, has been associated with the potential side effect of vitamin B(12) deficiency. This retrospective observational study aimed to evaluate the effect of concomitant metformin use on hematologic adverse events in patients with NSCLC undergoing pemetrexed-based chemotherapy using the Medical Data Vision Database. Patients with stage III or higher NSCLC who received pemetrexed from April 2008 to May 2021 were categorized into metformin-treated (MTF) and non-metformin-treated (non-MTF) groups. The primary outcome was the proportion of granulocyte colony-stimulating factor (G-CSF) administration during cycle (C) 1 to C2 or C2 to C3 of pemetrexed therapy. Propensity score matching (PSM) was used to balance the baseline characteristics between the groups. A total of 1174 patients met the inclusion criteria (54 in MTF and 1120 in non-MTF). After PSM, 52 patients were included in each group. The median metformin dosage in the MTF group was 500 mg/d before and 625 mg/d after PSM. There were no significant differences between the MTF and non-MTF groups in G-CSF administration (15.4 vs. 21.2%, p=0.446). Multivariate logistic regression analysis also showed that metformin use did not significantly affect hematologic toxicity (odds ratio: 1.208, 95% CI: 0.554-2.634). This suggests that the concomitant use of a relatively low dose of metformin is unlikely to significantly increase the risk of hematotoxicity in Japanese patients with NSCLC receiving pemetrexed-based chemotherapy. |
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| ジャーナル名 | Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan |
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| Pubmed追加日 | 2025/1/6 |
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| 投稿者 | Hayafune, Masahiro; Imai, Shungo; Kizaki, Hayato; Tsuchiya, Masami; Hori, Satoko |
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| 組織名 | Department of Pharmacy, Tokyo Metropolitan Tama Medical Center, Tokyo;Metropolitan Hospital Organization.;Division of Drug Informatics, Keio University Faculty of Pharmacy. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39756927/ |
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