The Influence of Performance Status, Inflammation, and Nutrition on the Impact of SGLT2 Inhibitors on Cancer Outcomes

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-03-21 DOI:10.1002/cam4.70807

Diego Rivas-Otero, Tomás González-Vidal, Pablo Agüeria-Cabal, Guillermo Ramos-Ruiz, Paula Jimenez-Fonseca, Carmen Lambert, Pedro Pujante Alarcón, Edelmiro Menéndez Torre, Miguel García-Villarino, Elías Delgado Álvarez

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Abstract

Background

Sodium–glucose-linked transporter 2 inhibitors (SGLT2i) may have antitumor effects. Previous studies analyzing their role in mortality and progression did not account for potential confounders, including cancer treatment, performance status, inflammatory markers, and nutritional status. This study aims to evaluate the impact of SGLT2i treatment on mortality and progression while considering these potential confounders.

Methods

A retrospective cohort study was conducted. A total of 526 patients with cancer (302 women, mean age 64 years, range 40–79 years) were divided into two cohorts based on whether they were taking SGLT2i at the time of their cancer diagnosis and followed for 1 year or until death. All patients on SGLT2i were taking these drugs at standard clinical doses. Additional data collected included basic demographic variables, metabolic and lifestyle characteristics, cancer treatment received, performance status, inflammatory markers, and nutritional status. The primary endpoints were mortality and progression.

Results

Patients taking SGLT2i at the time of cancer diagnosis (n = 41) were more likely to have type 2 diabetes, to be male, to be ever-smokers, and to be older than patients not taking SGLT2i. In univariate analyses, SGLT2i treatment at the time of cancer diagnosis was not associated with mortality or cancer progression. Instead, mortality and cancer progression were positively associated with a diagnosis of T2D, male sex, older age, heavy alcohol drinking, ever-smoker status, poor performance status, increased inflammation, malnutrition, tumor site, cancer stage, and lack of cancer treatment. After adjusting for these potential confounders, SGLT2i treatment was not significantly associated with mortality or cancer progression.

Conclusions

Our results suggest that the impact of SGLT2i treatment on cancer outcomes is limited under standard clinical dosing conditions.

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运动状态、炎症和营养对SGLT2抑制剂对癌症结局的影响

背景：钠-葡萄糖连接转运蛋白2抑制剂（SGLT2i）可能具有抗肿瘤作用。先前的研究分析了它们在死亡率和进展中的作用，但没有考虑到潜在的混杂因素，包括癌症治疗、运动状态、炎症标志物和营养状况。本研究旨在评估SGLT2i治疗对死亡率和进展的影响，同时考虑这些潜在的混杂因素。方法：采用回顾性队列研究。共有526名癌症患者（302名女性，平均年龄64岁，范围40-79岁）根据他们在癌症诊断时是否服用SGLT2i分为两组，随访1年或直到死亡。所有SGLT2i患者都以标准临床剂量服用这些药物。收集的其他数据包括基本人口统计学变量、代谢和生活方式特征、接受的癌症治疗、运动状态、炎症标志物和营养状况。主要终点是死亡率和进展。结果：与未服用SGLT2i的患者相比，在癌症诊断时服用SGLT2i的患者（n = 41）患2型糖尿病、男性、吸烟和年龄更大。在单变量分析中，癌症诊断时的SGLT2i治疗与死亡率或癌症进展无关。相反，死亡率和癌症进展与T2D诊断、男性、年龄较大、大量饮酒、经常吸烟、表现不佳、炎症增加、营养不良、肿瘤部位、癌症分期和缺乏癌症治疗呈正相关。在对这些潜在混杂因素进行校正后，SGLT2i治疗与死亡率或癌症进展无显著相关性。结论：我们的研究结果表明，在标准临床剂量条件下，SGLT2i治疗对癌症结局的影响有限。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.