二甲双胍可能还可治肺癌

美国“健康日”网站近日报道，前不久举行的美国癌症研究学会年会上发表的一项最新研究发现，在治疗2型糖尿病中广泛使用的药物二甲双胍也可以用于治疗肺癌。研究带头人、美国国家癌症研究所肿瘤医学高级研究员菲利普·丹尼斯博士说，二甲双胍对治疗由于吸烟而导致的肺癌，疗效尤其显著。
研究人员在对长期受到尼古丁侵害而患上肺癌的白鼠，进行连续13周的实验后发现，如果对这些白鼠喂食二甲双胍，其肺部的肿瘤会缩小40%—50%，而采用注射二甲双胍的方法来进行治疗，其肺部的肿瘤可缩小72%。研究人员表示，这一结果即将在人体上试验，被用作治疗肺癌药物的前景光明。

研究人员认为，二甲双胍预防吸烟引起的肺癌的依据是：这种药能通过降低IGF－1(类胰岛素生长因子)和血液中的胰岛素水平来达到抑制mTOR(雷帕霉素靶蛋白)的效果，而mTOR是一种能促进肺癌细胞增长的蛋白质。

可能又要面临剂量的困难，量多了，会低血糖；量少了，不能达到抗癌的作用。

如果有确切疗效，可以增加热量来应付低血糖，问题是这样一来是否要降低抗癌的疗效。
盼SHY进一步追踪并翻译这项资料，先谢了。

谢谢憨豆叔鼓励，我先找了一些资料，贴上，等下再翻译成中文

The Effect of Metformin and Thiazolidinedione Use on Lung Cancer
Peter J. Mazzone, MD*; Hardeep S. Rai, MD; Mary Beukemann, BS; Meng Xu, MS; Rania Abdallah, MD and Madhu Sasidhar, MD
Cleveland Clinic, Cleveland, OH

PURPOSE: The diabetes drugs metformin and TZDs may have a protective effect against the development or progression of lung cancer. A potential mechanism of this effect is through the activation of AMP-activated protein kinase (AMPK). Metformin directly activates, and TZDs indirectly activate, the AMPK pathway. When cells are faced with energy stresses AMPK functions to restore energy balance by inhibiting synthetic pathways and stimulating catabolic pathways. This function may serve to protect against lung cancer development or progression. The purpose of this study was to determine if diabetic patients who develop lung cancer and have been exposed to metformin or TZDs, have a different lung cancer presentation and course than diabetic patients who have not been exposed to these medications.

METHODS: The medical records of 157 diabetic patients who had a history of lung cancer were reviewed. Data collected included demographics, smoking history, diabetic medication use, and lung cancer characteristics (stage at presentation, histology, survival). Lung cancer characteristics were compared between the group that had been exposed to metformin and/or TZDs prior to their lung cancer diagnosis and those who had not received either of these medications prior to their lung cancer diagnosis.

RESULTS: There were no significant differences between the age, sex, and smoking histories of the group exposed to metformin or TZDs prior to their lung cancer diagnosis and the group who was not exposed. Those who were exposed had a lower chance of presenting with metastatic disease (20.0% vs. 42.4%, p=0.027). They were more likely to present with an adenocarcinoma and less likely to present with a small cell or squamous cell carcinoma (p=0.019). The HR for survival in the exposed group, after correction for stage, was 0.56 (p=0.056).

CONCLUSION: Diabetic patients with lung cancer who are previously exposed to metformin and/or TZDs are less likely to present with metastatic disease, more likely to present with an adenocarcinoma, and may survive longer.

CLINICAL IMPLICATIONS: The chemopreventive and treatment effects of these medications warrant additional study.

DISCLOSURE: Peter Mazzone, No Financial Disclosure Information; No Product/Research Disclosure Information
大概意思是：统计了157名患糖尿病和肺癌的患者，发现吃metformin or TZDs的更不容易转移，而且一般得的是腺癌，得小细胞癌和鳞癌的很少，同时他们的存活期更长。

In the first human trial of metformin as a cancer preventive, Kunihiro Hosono, MD, and colleagues from the Yokohama City University School of Medicine in Japan report that nondiabetic patients randomized to 1 month of low-dose of metformin (250 mg/day) had a significant decrease in the mean number of rectal aberrant crypt foci (ACF), an endoscopic surrogate marker of colorectal cancer.
最早用metformin （二甲双胍）治疗癌症的是日本Yokohama城市大学，多个病人服用metformin (250 mg/天)，其直肠隐窝灶有很明显减少。

如果是250mg的话，剂量相当低了，我婆婆糖尿病还不是很严重的，现在每天吃6*250mg呢

谢谢SHY提供的资料!我找了一个下午，没找到什么，但也决定吃了，因为我本身血糖稍偏高，需控制热量，如果250毫克的量，不大会影响血糖，500毫克以下也是可接受的。

那个加拿大医生在易瑞沙耐药后也给了如下建议
1. ribavirin（利巴韦林）+ metformin(二甲双胍); 不能与TM 同用, 但可与DCA 同用,
2.高剂量 tamoxifen(他莫昔芬), 可与TM 和DCA 同用, 需做心电图和B超监控心率和血栓.
当时，我也在网上搜了，也看到了类似文章，希望憨叔有效