Impact of DPP-4 Inhibitors on Survival of Patients with Non-Small Cell Lung Cancer - A Propensity Score-Matched Analysis

Pang-Chieh Hung；Kuang-Tai Kuo；Tung-Yu Tiong；Yuan-Hung Wang；Wei-Ciao, Wu

DPP4i ； diabetes mellitus ； non-small cell lung cancer

胸腔醫學

39卷3期（2024 / 09 / 01）

198 - 207

英文

Introduction: Diabetes mellitus (DM) and cancer coexist in 8-18% of individuals with DM. Dipeptidyl peptidase-4 inhibitor (DPP4i) is one of the hypoglycemic agents (OHA) that have been found to be beneficial with various cancer patients, either in vitro or in vivo. The aim of this study was to retrospectively examine overall survival (OS) with or without the usage of DPP4i in DM patients with non-small cell lung cancer. Methods: This single-center, propensity score-matched, retrospective comparative study using electronic medical records evaluated DM patients with non-small cell lung adenocarcinoma between January 2011 and December 2019 at Shuang Ho Hospital, Taiwan. Patients were divided into Group 1, in which DPP4i was not taken with other OHA, and Group 2, in which DPP4i was taken combined with other OHA. We compared the OS between the 2 groups and tried to find some covariate that would influence OS in DM lung cancer patients. Results: We enrolled 193 patients (150 in the non-DDP4i group (Group 1), and 43 in the DDP4i group (Group 2)); 86 patients in Group 1 and 43 patients in Group 2 were matched using propensity scores. In the matched cohorts, patients in the non-DDP4i group had poorer OS than those in the non-DPP4i group, although without statistical significance; for 1-year, 2-year and 5-year OS, the hazard ratios were 1.37 (P = 0.304; 95% CI 0.753-2.479), 1.37 (P = 0.2; 95% CI 0.848-2.207) and 1.32 (P = 0.17; 95% Cl: 0.890-1.946), respectively. Conclusion: Dipeptidyl peptidase IV inhibitor (DPP4i) may have a benefit for OS in NSCLC patients with comorbidity of DM, although there was no significant difference due to the sample size. Among the DM lung cancer patients, female sex would be a better prognostic factor for OS.