Metformin as an adjuvant treatment for cancer: a systematic review and meta-analysis.

In studies in non-Western populations, there was a highly significant benefit of metformin on OS (HR 0.36, CI 0.25–0.53); however, there was evidence of heterogeneity ( I 2 = 85.8%, P = 0.013).

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For men with early-stage prostate cancer, metformin was associated with significant, or borderline significant, benefits in all outcomes (RFS HR 0.83, CI 0.69–1.00; OS HR 0.82, CI 0.73–0.93; CSS HR 0.58, CI 0.37–0.93); however, there was significant heterogeneity between studies.

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In head and neck cancer, a positive trend towards improved RFS and CSS was seen in one study [ 57 ], but there was no effect on OS.

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Two meta-analyses identified a significant benefit in OS [ 21 , 23 , 28 ], the other approached significance (HR 0.81, CI 0..64–1.04) [ 22 ] and the two meta-analyses investigating breast CSS also showed significant improvements [ 23 , 28 ].

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