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The Clinical Potentials of Combining Paclitaxel-Based Chemotherapy Regimen With Metformin in Cancer Treatment: A Systematic Review and Meta-Analysis Publisher



B Omidi Sarajar BEHNAM ; N Rastegarpouyani NIMA ; A Rasouli AZADEH ; F Nikbakht FATEME ; M Nezami Majd MAHDIEH ; Mh Ghahremani Mohammad HOSSEIN ; Sn Ostad Seyed NASSER ; E Jafarzadeh EMAD ; M Dehghani MOHSEN
Authors

Source: Translational Oncology Published:2025


Abstract

Background: Several clinical trials have shown that combining metformin with paclitaxel-based chemotherapy has a promising effect on various tumors but with inconsistent findings. We conducted a systematic review and meta-analysis to compare the effects of paclitaxel plus metformin versus paclitaxel-based chemotherapy alone in different organ neoplasms. Methods: A comprehensive literature search was performed in Scopus, PubMed, Web of Sciences, Embase and also Google scholar until December 2023 using MeSH keywords and all similar terms limited to randomized controlled trials (RCTs). The retrieved studies were assessed for methodological quality. Pooled standardize mean difference (SMD), odds ratio (OR) and 95 % confidence intervals (CI) of clinical outcomes were calculated using random-effects meta-analysis. Results: Of 921 records, ultimately, 14 RCTs met the criteria for inclusion in the meta-analysis. Based on a meta-analysis findings, combination therapy of a paclitaxel-based regimen with metformin was found to be significantly associated with improved overall survival (OS) compared to the paclitaxel alone in various types of cancers (pooled SMD: 1.27; 95 % CI: 0.10, 2.43). Moreover, the metformin plus paclitaxel showed a borderline significant improvement in the pathological complete response (pCR) rate compared to the paclitaxel alone (Pooled OR: 1.74; 95 % CI: 0.96, 3.15). However, there was no significant improvement in the metformin plus paclitaxel group compared to the paclitaxel group for progression-free survival (PFS) and disease-free survival (DFS). Conclusion: The findings indicate that a combination of paclitaxel-based chemotherapy with metformin enhances OS and pCR in cancer patients. This combination therapy has the potential to improve treatment effectiveness and safety. © 2025 Elsevier B.V., All rights reserved.
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