Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast Cancer
Background: Dipeptidyl peptidase-4 (DPP4), a cell surface protein, exhibits a crucial role in tumor biology and regulation of the immune system. We aim to study the impact of DPP4 inhibitors (DPP4i) in patients with prostate cancer (PRC), pancreatic cancer (PC) and breast cancer (BC).Methods: Using...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.00405/full |
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| author | Chintan Shah Young-Rock Hong Rohit Bishnoi Azka Ali William Paul Skelton Long H. Dang Jinhai Huo Nam H. Dang |
| author_facet | Chintan Shah Young-Rock Hong Rohit Bishnoi Azka Ali William Paul Skelton Long H. Dang Jinhai Huo Nam H. Dang |
| author_sort | Chintan Shah |
| collection | DOAJ |
| description | Background: Dipeptidyl peptidase-4 (DPP4), a cell surface protein, exhibits a crucial role in tumor biology and regulation of the immune system. We aim to study the impact of DPP4 inhibitors (DPP4i) in patients with prostate cancer (PRC), pancreatic cancer (PC) and breast cancer (BC).Methods: Using the SEER and Medicare linked database, we identified patients with PRC or PC or BC with coexisting type II diabetes mellitus between 2007 and 2015. Patients were classified into four groups: (1) not on either DPP4i or metformin (reference group), this group included patient that were on anti-diabetic agents other than metformin or DPP4i (2) metformin only, (3) DPP4i only, and (4) DPP4i along with metformin (combination group). Overall survival (OS) analyses were performed using SAS®, version 9.4.Results: We identified 15,330 patients with PRC, 5,359 patients with PC and 16,085 patients with BC. In PRC cohort, patients on DPP4i had significant survival advantage with HR 0.77 (95% CI: 0.64–0.93), P = 0.005 when compared to the reference group. Patients taking metformin also had significant OS benefit with HR 0.87 (95% CI: 0.81–0.93), P < 0.0001 when compared to the reference group. However, in BC cohort, OS did not favor the patients taking DPP4i with HR 1.07 (95% CI: 0.93–1.25, P = 0.33). Similarly, in PC cohort, OS was indifferent for the patients on DPP4i with HR 1.07 (95% CI: 0.93–1.24, P = 0.68). Upon subgroup analyses of PRC patients, the survival favored the group taking DPP4i, irrespective of stage, use of chemotherapy, androgen-deprivation therapy, and prostatectomy or radiation therapy.Conclusions: DPP4i seems to improve survival in PRC patients; however, not in PC or BC patients. While the exact mechanism involved remains to be elucidated, a prospective clinical trial would help to confirm these findings. |
| first_indexed | 2024-12-21T07:41:30Z |
| format | Article |
| id | doaj.art-2f3be9ac5ba84f3d8a3b514e8494974e |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-21T07:41:30Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-2f3be9ac5ba84f3d8a3b514e8494974e2022-12-21T19:11:19ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-03-011010.3389/fonc.2020.00405502882Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast CancerChintan Shah0Young-Rock Hong1Rohit Bishnoi2Azka Ali3William Paul Skelton4Long H. Dang5Jinhai Huo6Nam H. Dang7Division of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, FL, United StatesDepartment of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United StatesDivision of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, FL, United StatesDivision of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, FL, United StatesDivision of Medical Oncology, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL, United StatesOchsner Medical Center, Baton Rouge, LA, United StatesDepartment of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United StatesDivision of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, FL, United StatesBackground: Dipeptidyl peptidase-4 (DPP4), a cell surface protein, exhibits a crucial role in tumor biology and regulation of the immune system. We aim to study the impact of DPP4 inhibitors (DPP4i) in patients with prostate cancer (PRC), pancreatic cancer (PC) and breast cancer (BC).Methods: Using the SEER and Medicare linked database, we identified patients with PRC or PC or BC with coexisting type II diabetes mellitus between 2007 and 2015. Patients were classified into four groups: (1) not on either DPP4i or metformin (reference group), this group included patient that were on anti-diabetic agents other than metformin or DPP4i (2) metformin only, (3) DPP4i only, and (4) DPP4i along with metformin (combination group). Overall survival (OS) analyses were performed using SAS®, version 9.4.Results: We identified 15,330 patients with PRC, 5,359 patients with PC and 16,085 patients with BC. In PRC cohort, patients on DPP4i had significant survival advantage with HR 0.77 (95% CI: 0.64–0.93), P = 0.005 when compared to the reference group. Patients taking metformin also had significant OS benefit with HR 0.87 (95% CI: 0.81–0.93), P < 0.0001 when compared to the reference group. However, in BC cohort, OS did not favor the patients taking DPP4i with HR 1.07 (95% CI: 0.93–1.25, P = 0.33). Similarly, in PC cohort, OS was indifferent for the patients on DPP4i with HR 1.07 (95% CI: 0.93–1.24, P = 0.68). Upon subgroup analyses of PRC patients, the survival favored the group taking DPP4i, irrespective of stage, use of chemotherapy, androgen-deprivation therapy, and prostatectomy or radiation therapy.Conclusions: DPP4i seems to improve survival in PRC patients; however, not in PC or BC patients. While the exact mechanism involved remains to be elucidated, a prospective clinical trial would help to confirm these findings.https://www.frontiersin.org/article/10.3389/fonc.2020.00405/fullDPP4 (Dipeptidyl peptidase 4) inhibitorscancersitagliptinJanuviaprostatebreast |
| spellingShingle | Chintan Shah Young-Rock Hong Rohit Bishnoi Azka Ali William Paul Skelton Long H. Dang Jinhai Huo Nam H. Dang Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast Cancer Frontiers in Oncology DPP4 (Dipeptidyl peptidase 4) inhibitors cancer sitagliptin Januvia prostate breast |
| title | Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast Cancer |
| title_full | Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast Cancer |
| title_fullStr | Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast Cancer |
| title_full_unstemmed | Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast Cancer |
| title_short | Impact of DPP4 Inhibitors in Survival of Patients With Prostate, Pancreas, and Breast Cancer |
| title_sort | impact of dpp4 inhibitors in survival of patients with prostate pancreas and breast cancer |
| topic | DPP4 (Dipeptidyl peptidase 4) inhibitors cancer sitagliptin Januvia prostate breast |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.00405/full |
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