Poor glycemic control might compromise the efficacy of chemotherapy in non-small cell lung cancer patients with diabetes mellitus

Background Previous studies indicated that type 2 diabetes mellitus (T2DM) is related to an increased lung cancer risk, but its role in the prognosis of NSCLC remains conflicting. This study investigated the impact of blood glucose control on the outcomes in NSCLC patients with T2DM treated with platinum-based doublets. Methods Clinicopathological and survival data from 191 T2DM patients with advanced NSCLC, who received platinum-based chemotherapy, were retrospectively analyzed. Based on the blood glucose conditions during chemotherapy, patients were classified into poor (n = 84) and good control (n = 107) groups. Progression-free survival (PFS) was assessed using the Kaplan-Meier method. Results The median PFS among patients with good glycemic control [197.0 (95% CI: 136.3-257.7) days] was longer than that among those with poor control [132.0 (95% CI: 112.5-151.5) days] (P = .0003). Further subgroup analysis of lung squamous carcinoma and adenocarcinoma patients showed that the median PFS of the good control group was also significantly longer than that of the poor control group [179.0 (95% CI: 78.4-279.6) days vs 125.0 (95% CI: 110.9-139.1) days, P = .0014; 197.0 (95% CI: 124.3-269.7) days vs 154.0 (95% CI: 129.9-178.1) days, P = .0359; respectively]. The incidence rates of side effects were similar among patients with good glycemic control and those with poor glycemic control (all P > .05). Conclusions Satisfactory glycemic control during platinum-based chemotherapy might provide a survival benefit to T2DM patients with NSCLC. Further studies are warranted to confirm our findings.