1. Effects of Metformin and Vitamin D on Clinical Outcome in Cholangiocarcinoma Patients
- Author
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Margherita Rimini, Antonella Argentiero, Giulia Bartolini, Oronzo Brunetti, Nicola Silvestris, Giovanni Luca Frassineti, Andrea Casadei-Gardini, Elisa Sperti, Giulia Rovesti, Laura Bernardini, Francesco Giovannelli, Rosa La Face, Roberto Filippi, Caterina Vivaldi, Giacomo Aimar, Martina Valgiusti, Ilario Giovanni Rapposelli, Luca Aldrighetti, Virginia Quarà, Stefano Cascinu, Elisabetta Fenocchio, Francesco Leone, Silvia Cesario, Francesca Ratti, Lorenzo Fornaro, Kalliopi Andrikou, Casadei-Gardini, A., Filippi, R., Rimini, M., Rapposelli, I. G., Fornaro, L., Silvestris, N., Aldrighetti, L., Aimar, G., Rovesti, G., Bartolini, G., Vivaldi, C., Brunetti, O., Sperti, E., La Face, R., Ratti, F., Andrikou, K., Valgiusti, M., Bernardini, L., Argentiero, A., Fenocchio, E., Frassineti, G. L., Cesario, S., Giovannelli, F., Quara, V., Leone, F., and Cascinu, S.
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Disease-free survival ,medicine.medical_treatment ,Biliary tract cancer ,Chemotherapy ,Cholangiocarcinoma ,Gallbladder cancer ,Metfromin ,Vitamin D ,Bile Duct Neoplasms ,Female ,Follow-Up Studies ,Humans ,Hypoglycemic Agents ,Metformin ,Prognosis ,Retrospective Studies ,Survival Rate ,Vitamins ,Internal medicine ,medicine ,Vitamin D and neurology ,In patient ,Prospective cohort study ,Aspirin ,business.industry ,Vitamin D intake ,General Medicine ,medicine.disease ,Oncology ,business ,medicine.drug - Abstract
Background and Aims: In the last few years, there has been increasing interest in non-cancer medications and their potential anti-cancer activity. Data are not available in cholangiocarcinoma (CCA) patients. The aim of this study is to fill this gap by investigating the potential impact in terms of clinical outcome of the common non-cancer medications. Methods: All consecutive patients with CCAs were retrospectively identified from 7 Italian medical institutions. We investigated the role of intake of vitamin D, aspirin, metformin, statins, and diuretics. Results: A total of 537 patients with CCAs were identified; 197 patients undergoing surgery were evaluated for disease-free survival (DFS), and 509 patients with an advanced stage were evaluated for overall survival (OS). A longer DFS was found in patients with intake of vitamin D versus never users (HR 0.55, 95% CI 0.32–0.92, p = 0.02). In an advanced stage an association with OS was found in patients with intake of metformin versus never users (HR 0.70, 95% CI 0.52–0.93, p = 0.0162), and in patients who have started taking metformin after chemotherapy versus before chemotherapy and never users (HR 0.44, 95% CI 0.26–0.73, p = 0.0016). Conclusions: Our results highlighted that vitamin D intake improves DFS in patients undergoing surgery. Metformin intake after starting chemotherapy can improve the clinical outcome in advanced disease. These results could open up new therapeutic strategies in cholangiocarcinoma patients. We are planning to undertake a prospective study to validate these data.
- Published
- 2021