THE INFLUENCE OF ANTIDIABETIC MEDICATIONS ON THE DEVELOPMENT AND PROGRESSION OF PROSTATE CANCER

The development of prostate tumors has been linked to co-morbid diabetes mellitus (DM) in several studies, potentially through the stimulation of insulin-like growth factor receptor (IGFR). This study evaluates the effect of anti-diabetic medication use on the development of high grade tumors and time to tumor progression compared to non-diabetics. This retrospective, nested case control study identified patients with prostate cancer (PCa) from the Kentucky Medicaid Database. Cases were diagnosed with PCa and DM and using at least one of the following antidiabetic medications; sulfonylureas, insulin, metformin or TZDs. Cases were further stratified on their insulin exposure resulting from therapy. Controls were those with PCa without DM or any anti-diabetic medications. No statistically significant effects on insulin exposure was found on tumor grade and time to progression. Trends identified that use of metformin or TZDs potentially decreased the odds of high-grade tumors and decreased the risk of progression, while sulfonylureas and high-dose insulin may increase the odds of high-grade tumors and increase the risk of progression compared to non-diabetics. Future studies should be conducted to further evaluate the effects of anti-diabetic medications on tumor grade and time to prostate cancer progression

The influence of antidiabetic medications on the development and progression of prostate cancer

AbstractBackgroundThe development of prostate tumors has been linked to co-morbid diabetes mellitus (DM) in several studies, potentially through the stimulation of insulin-like growth factor receptor (IGFR). This study evaluates the effect of anti-diabetic medication use on the development of high grade tumors and time to tumor progression compared to non-diabetics.MethodsThis retrospective, nested case control study identified patients with prostate cancer (PCa) from the Kentucky Medicaid Database. Cases were diagnosed with PCa and DM and using at least one of the following antidiabetic medications; sulfonylureas, insulin, metformin or TZDs. Cases were further stratified on their insulin exposure resulting from therapy. Controls were those with PCa without DM or any anti-diabetic medications.ResultsThe use of metformin or TZDs trended toward decreased odds of high-grade tumors and decreased risk of progression, while sulfonylureas and high-dose insulin tended toward an increased odds of high-grade tumors and increase the risk of progression compared to non-diabetics.ConclusionsFuture studies should be conducted to further evaluate the effects of anti-diabetic medications on tumor grade and time to prostate cancer progression

Incidence and risk factors of clinically significant chemotherapy-induced thrombocytopenia in patients with solid tumors

Purpose and relevance. Chemotherapy-induced thrombocytopenia (CIT) can be a significant problem in patients with cancer, leading to numerous clinical complications. Understanding the types of patients at risk for these complications is essential to improve monitoring, counseling, and provide future targeted prophylaxis measures. Previous studies have limited prospective utility since they do not examine risk factors associated with complications from multi-agent regimens. This evaluation aims to identify the incidence and risk factors associated with clinical complications of CIT in patients receiving common chemotherapy regimens. Methods. Retrospective evaluation of adult patients receiving first or second line regimens for the most common solid tumors associated with high rates (≥5%) of laboratory diagnosed thrombocytopenia. Patients were examined for clinically significant CIT (defined as platelet count &lt;75,000 cells/µL as well as the presence of one of the following: bleeding, dose reduction/delay, platelet transfusion, or therapy cessation) and associated risk factors. Results. About 254 patients receiving a total of 278 regimens were evaluated. The incidence of clinically significant CIT = 10.1%; complications were most common in patients receiving cisplatin/gemcitabine for bladder cancer (57%), or carboplatin/gemcitabine (29%) or cisplatin/etoposide (18%) for lung cancer. Bladder cancer (OR = 13.7 (2.89–64.7); p = 0.001) and concurrent or recent infection (OR = 3.8 (1.45–10.1); p = 0.007) was found to increase the risk of clinical complications while smoking was found to have a protective effect (OR = 0.17 (0.04–0.71)). Conclusions. The incidence of clinically significant CIT is most commonly seen in patients using cisplatin/gemcitabine for bladder cancer, or carboplatin/gemcitabine or cisplatin/etoposide for lung cancer. Further evaluation of these patients is warranted. </jats:p