Sodium-glucose cotransporter 2 (SGLT2) inhibitors and non-small cell lung cancer survival

Br J Cancer. 2023 Apr;128(8):1541-1547. doi: 10.1038/s41416-023-02177-2. Epub 2023 Feb 10.

Abstract

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs with demonstrated renal and cardiovascular disease benefit. This study evaluates the role of SGLT2 inhibitors on the survival of non-small cell lung cancer (NSCLC) patients.

Methods: We used National Surveillance, Epidemiology and End Results (SEER)-Medicare linked data. Twenty four thousand nine hundred fifteen NSCLC patients newly diagnosed between 2014 and 2017 with pre-exiting diabetes and aged 66 years or older were included and followed to the end of 2019. Information on SGLT2 inhibitors use was extracted from the Medicare Part D file.

Results: SGLT2 inhibitor use was associated with significantly reduced mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.60-0.77) with stronger association for longer duration of use (HR = 0.54, 85% CI = 0.44-0.68). Further, we found that SGLT2 inhibitor use was associated with a significant reduced risk of mortality regardless of patients' demographic, tumour characteristics and cancer treatments.

Conclusion: Our large SEER-Medicare linked data study indicates that SGLT2 inhibitors use was associated with improved overall survival of NSCLC patients with pre-existing diabetes. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung* / complications
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucose
  • Humans
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Medicare
  • Prediabetic State*
  • Sodium
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
  • United States / epidemiology

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Sodium-Glucose Transporter 2
  • Glucose
  • Sodium