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Preventive and Therapeutic effects of Metformin in Cancer: A Meta- Analysis of RCT and Cohort Studies

Getu MA, Zhang X, Wang J, Xu K, Ying Y, Ma L, Gong P

Current cancer drug targets, 2026

1,300,820 participants · 2 citations

Abstract

BACKGROUND

There is discrepancy of results among various individual and me-ta-analytical studies about the effect of metformin on cancer risk and patients' survival. Therefore, we have conducted a comprehensive, updated meta-analysis to evaluate the preventive and therapeutic effects of metformin for cancer patients, as well as the inci-dence of adverse reactions, among metformin users.

METHODS

A total of 18 studies (10 cohort studies and 8 randomized controlled trials) in-volving 1,300,820 participants from Europe, North America, and Asia were included in this meta-analysis.

RESULTS

No significant association was found between metformin use and overall survival (Hazard ratio = 1.02; 95% CI, 0.80 - 1.30) and progressive-free survival (Hazard ratio = 1.00; 95% CI, 0.76 - 1.31). In addition, the summary risk estimates for adverse reactions of metformin were not statistically significant between intervention and control groups (Risk Ratio = 1.11; 95% CI, 0.94 - 1.31). However, metformin use was associated with a reduction in cancer risk (Hazard ratio = 0.90, 95% CI, 0.86 - 0.94).

CONCLUSION

Metformin does not significantly prolong the overall survival and progressive-free survival of cancer patients, but it may effectively reduce the risk of cancer occurrence.

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,300,820 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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