* Corresponding Author
Hubungan Penyakit Diabetes Melitus dan Penggunaan Antidiabetes terhadap Rekurensi pada Pasien Kanker Payudara
https://doi.org/10.22146/jmpf.48069 Fitri Wulandari(1), Kartika Widayati(2), Fita Rahmawati(3*)
(1) Program Pascasarjana Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta
(2) Instalasi Kanker Terpadu “Tulip” Rumah Sakit Umum Pendidikan dr.Sardjito, Yogyakarta, Indonesia
(3) Departemen Farmakologi dan Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author
Abstract
Breast cancer is the cancer with the most prevalence of 43.3% and the mortality rate that reaches 12.9%. The prognosis of breast cancer can be affected by diabetes mellitus (DM), so that efforts to control DM through antidiabetic therapy are very necessary, but antidiabetic therapy is also reported to be associated with the prognosis of breast cancer. The purpose of this study was to determine the relationship of diabetes and antidiabetic use to recurrence in breast cancer patients. This study used a retrospective cohort design, involving 176 female non-metastatic breast cancer patients who received chemotherapy, consisting of 88 patients with DM and 88 non-DM patients. The exposures in the study were diabetes mellitus and the types of antidiabetic drugs (metformin and non metformin based therapy), while the study output was the recurrence of breast cancer. The research data was obtained from the patient’s medical records at RSUP Dr. Sardjito Yogyakarta. Research analysis used Chi-square, Kaplan Meier method and Cox-regression to estimate Hazard Ratio with 95% confidence interval. The results showed DM in breast cancer patients was associated with increased the risk of recurrence (HR 2,458; 95% CI 1,571-3,846, log rank test P=0,000), while the use of antidiabetic types (metformin and nonmetformin) to control DM in breast cancer patients was not associated with the risk of recurrence (HR 1.391; 95% CI 0.816 - 2.370, log rank test P=0.210). Further research is warranted by monitoring blood glucose levels regularly.
Keywords
Full Text:
PDFReferences
1. Kemenkes RI. Stop Kanker. 2015.
2. Kemenkes RI. Infodatin - Hari Diabetes Sedunia. 2018.
3. Calip GS, Yu O, Hoskins KF, Boudreau DM. Associations between diabetes medication use and risk of second breast cancer events and mortality. Cancer Causes Control. 2015;26(8):1065-1077. doi:10.1007/s10552-015-0599-z
4. Bronsveld HK, Jensen V, Vahl P, et al. Diabetes and Breast Cancer Subtypes. Ahmad A, ed. PLOS ONE. 2017;12(1):1-16. doi:10.1371/journal.pone.0170084
5. Zhao X-B, Ren G-S. Diabetes mellitus and prognosis in women with breast cancer: A systematic review and meta-analysis. Medicine (Baltimore). 2016;95(49):e5602. doi:10.1097/MD.0000000000005602
6. Besic N, Satej N, Ratosa I, et al. Long-term use of metformin and the molecular subtype in invasive breast carcinoma patients – a retrospective study of clinical and tumor characteristics. BMC Cancer. 2014;14(1). doi:10.1186/1471-2407-14-298
7. Kim HJ, Kwon H, Lee JW, et al. Metformin increases survival in hormone receptor-positive, HER2-positive breast cancer patients with diabetes. Breast Cancer Res. 2015;17(1). doi:10.1186/s13058-015-0574-3
8. Chen L, Chubak J, Boudreau DM, Barlow WE, Weiss NS, Li CI. Diabetes Treatments and Risks of Adverse Breast Cancer Outcomes among Early-Stage Breast Cancer Patients: A SEER-Medicare Analysis. Cancer Res. 2017;77(21):6033-6041. doi:10.1158/0008-5472.CAN-17-0687
9. Sonnenblick A, Agbor-Tarh D, Bradbury I, et al. Impact of Diabetes, Insulin, and Metformin Use on the Outcome of Patients With Human Epidermal Growth Factor Receptor 2–Positive Primary Breast Cancer: Analysis From the ALTTO Phase III Randomized Trial. J Clin Oncol. 2017;35(13):1421-1429. doi:10.1200/JCO.2016.69.7722
10. Park HK. Metformin and Cancer in Type 2 Diabetes. Diabetes Metab J. 2013;37(2):113. doi:10.4093/dmj.2013.37.2.113
11. Vallianou NG, Evangelopoulos A, Kazazis C. Metformin and Cancer. Rev Diabet Stud. 2013;10(4):228-235. doi:10.1900/RDS.2013.10.228
12. Yudhani RD. Epidemiological and Experimental Studies: The Role of Metformin on Colorectal Cancer. Indones J Clin Pharm. 2016;5(4):258-268. doi:10.15416/ijcp.2016.5.4.258
13. Jayalie VF, William A, Irawan C. Peran Metformin sebagai Inhibitor Jaras Insulin-like Growth Factor-1 Receptor (IGF-1R), Epidermal Growth Factor Receptor (EGFR), dan. Contin Prof Dev. 2016;43(6):6.
14. Cianfrocca M, Goldstein LJ. Prognostic and Predictive Factors in Early-Stage Breast Cancer. Oncol Breast Cancer. 2004;9:606-616.
15. Amandito R, Viryawan C, Santoso F, Gautami W, Panigoro SS. The Characteristics of Breast Cancer Patients in “Dharmais” Hospital National Cancer Center Jakarta Based on Occupational and Environmental Status. Indones J Cancer. 2014;7:2:53-59.
16. Chen H, Zhou M, Tian W, Meng K, He H. Effect of Age on Breast Cancer Patient Prognoses: A Population-Based Study Using the SEER 18 Database. Coleman WB, ed. PLOS ONE. 2016;11(10):e0165409. doi:10.1371/journal.pone.0165409
17. Munsell MF, Sprague BL, Chisholm G, Trentham-Dietz A. Body Mass Index and Breast Cancer Risk According to Postmenopausal Estrogen-Progestin Use and Hormone Receptor Status. Epidemiol Rev Oxf Univ Press. 2014;36:114-136.
18. Kaplan MA, Pekkolay Z, Kucukoner M, et al. Type 2 diabetes mellitus and prognosis in early stage breast cancer women. Med Oncol. 2012;29(3):1576-1580. doi:10.1007/s12032-011-0109-4
19. Sun L, Zhu Y, Qian Q, Tang L. Body mass index and prognosis of breast cancer: An analysis by menstruation status when breast cancer diagnosis. Medicine (Baltimore). 2018;97(26):e11220. doi:10.1097/MD.0000000000011220
20. Iyengar NM, Arthur R, Manson JE, et al. Association of Body Fat and Risk of Breast Cancer in Postmenopausal Women With Normal Body Mass Index. JAMA Onkol. 2019:E1-E9.
21. Dyanti GAR, Suariyani NLP. Faktor-faktor Keterlambatan Penderita Kanker Payudara dalam Melakukan Pemeriksaan Awal ke Pelayanan Kesehatan. J Kesehat Masy. 2016;11(2):276. doi:10.15294/kemas.v11i2.3742
22. Fallahpour S, Navaneelan T, De P, Borgo A. Breast cancer survival by molecular subtype: a population-based analysis of cancer registry data. CMAJ Open. 2017;5(3):E734-E739. doi:10.9778/cmajo.20170030
23. Abubakar M, Sung H, Bcr D, et al. Breast cancer risk factors, survival and recurrence, and tumor molecular subtype: analysis of 3012 women from an indigenous Asian population. Breast Cancer Res. 2018;20(1). doi:10.1186/s13058-018-1033-8
24. Andreopoulou E, Sparano JA. Chemotherapy in Patients with Anthracycline- and Taxane-Pretreated Metastatic Breast Cancer: An Overview. Curr Breast Cancer Rep Springer. 2013;5(1):42-50.
25. Zaheed M, Wilcken N, Willson ML, O’connell D, Goodwin A. Sequencing of Anthracyclines and Taxanes in Neoadjuvant and Adjuvant Therapy for Early Breast Cancer. Cochrane Database Syst Rev. 2019;(2):1-4.
26. Burstein HJ. Adjuvant chemotherapy for HER2-negative breast cancer. Hayes DF, Vora SR, eds. 2018.
27. Ntellas P, Spathas N, Agelaki S, Zintzaras E, Saloustros E. Taxane & cyclophosphamide vs anthracycline & taxane-based chemotherapy as adjuvant treatment for breast cancer: a pooled analysis of randomized controlled trials by the Hellenic Academy of Oncology. Oncotarget. 2019;10(11). doi:10.18632/oncotarget.26632
28. Ferroni P, Riondino S, Buonomo O, Palmirotta R, Guadagni F, Roselli M. Type 2 Diabetes and Breast Cancer: The Interplay between Impaired Glucose Metabolism and Oxidant Stress. Oxid Med Cell Longev. 2015;2015:1-10. doi:10.1155/2015/183928
29. Kishore J, Goel M, Khanna P. Understanding Survival Analysis: Kaplan-Meier Estimate. Int J Ayurveda Res. 2010;1(4):274. doi:10.4103/0974-7788.76794
30. Peairs KS, Barone BB, Snyder CF, et al. Diabetes Mellitus and Breast Cancer Outcomes: A Systematic Review and Meta-Analysis. J Clin Oncol. 2011;29(1):40-46. doi:10.1200/JCO.2009.27.3011
31. Oppong BA, Pharmer LA, Oskar S, et al. The effect of metformin on breast cancer outcomes in patients with type 2 diabetes. Cancer Med. 2014;3(4):1025-1034. doi:10.1002/cam4.259
32. Lega IC, Austin PC, Gruneir A, Goodwin PJ, Rochon PA, Lipscombe LL. Association Between Metformin Therapy and Mortality After Breast Cancer: A population-based study. Diabetes Care. 2013;36(10):3018-3026. doi:10.2337/dc12-2535
33. Dowling RJO, Niraula S, Stambolic V, Goodwin PJ. Metformin in cancer: translational challenges. J Mol Endocrinol. 2012;48(3):R31-R43. doi:10.1530/JME-12-0007
34. Liu B, Fan Z, Edgerton SM, Yang X, Lind SE, Thor AD. Potent anti-proliferative effects of metformin on trastuzumab-resistant breast cancer cells via inhibition of erbB2/IGF-1 receptor interactions. Cell Cycle. 2011;10(17):2959-2966. doi:10.4161/cc.10.17.16359
35. Bayraktar S, Hernadez-Aya LF, Lei X, et al. Effect of metformin on survival outcomes in diabetic patients with triple receptor-negative breast cancer. Cancer. 2012;118(5):1202-1211. doi:10.1002/cncr.26439
36. He X, Esteva FJ, Ensor J, Hortobagyi GN, Lee M-H, Yeung S-CJ. Metformin and thiazolidinediones are associated with improved breast cancer-specific survival of diabetic women with HER2+ breast cancer. Ann Oncol. 2012;23(7):1771-1780. doi:10.1093/annonc/mdr534
.
DOI: https://doi.org/10.22146/jmpf.48069
Article Metrics
Abstract views : 2878
| 
views : 4035
Refbacks
- There are currently no refbacks.
Copyright (c) 2019 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
