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Background <p>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are commonly used to manage diabetes and are known to cause weight loss. This study aimed to clarify whether SGLT2i-induced weight loss influences survival or toxicity during systemic therapy in patients with advanced non-small cell lung cancer (NSCLC) and comorbid diabetes.</p> Methods <p>We conducted a retrospective analysis of patients with advanced NSCLC and diabetes who received first-line systemic therapy. Patients with an Eastern Cooperative Oncology Group performance status (PS) ≥ 3, driver mutations, interstitial lung disease, untreated diabetes, or missing data were excluded. We compared weight changes, progression-free survival (PFS), overall survival (OS), and adverse events between patients with and without SGLT2i. We defined cachexia as either 5% or more body-weight loss within six months prior to the initiation of lung cancer treatment or weight loss greater than 2% and a body-mass index (BMI) of less than 20&#xa0;kg/m<sup>2</sup>.</p> Results <p>Eighteen patients (21.9%) out of 82 received SGLT2i for diabetes. There was no difference in the incidence of cachexia between the two groups (66.7% vs. 46.9%, <i>p </i>= 0.184), despite significant weight loss in the SGLT2 group compared to the non-SGLT2 group (median − 5.8% vs. − 3.4%, <i>p </i>= 0.039). No significant differences were observed in progression-free survival (PFS) (median 6.2 vs. 4.1&#xa0;months, <i>p </i>= 0.512) or overall survival (OS) (median 11.9 vs. 14.6&#xa0;months,<i> p</i> = 0.583). Grade ≥ 3 adverse events occurred in 11.1% of patients in the SGLT2i group and 31.2% of patients in the non-SGLT2i group (<i>P </i>= 0.132). There were no cases of diabetic ketoacidosis or urinary tract infections.</p> Conclusion <p>SGLT2 inhibitors were associated with weight loss and were not associated with worse survival or increased toxicity in this limited retrospective cohort.</p>

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Weight change and impact on prognosis in patients with advanced non-small cell lung cancer with concomitant diabetes mellitus treated with sglt2 inhibitors

  • 期刊论文

  • 发表日期：

    2026年4月28日

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  • Noboru Morikawa,
  • Tateaki Naito,
  • Yuta Okawa,
  • Suguru Matsuda,
  • Meiko Morita,
  • Motoki Sekikawa,
  • Kosei Doshita,
  • Michitoshi Yabe,
  • Hiroaki Kodama,
  • Keita Miura,
  • Yuko Iida,
  • Nobuaki Mamesaya,
  • Haruki Kobayashi,
  • Ryo Ko,
  • Akira Ono,
  • Hirotsugu Kenmotsu,
  • Haruyasu Murakami,
  • Toshiaki Takahashi

摘要

Background

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are commonly used to manage diabetes and are known to cause weight loss. This study aimed to clarify whether SGLT2i-induced weight loss influences survival or toxicity during systemic therapy in patients with advanced non-small cell lung cancer (NSCLC) and comorbid diabetes.

Methods

We conducted a retrospective analysis of patients with advanced NSCLC and diabetes who received first-line systemic therapy. Patients with an Eastern Cooperative Oncology Group performance status (PS) ≥ 3, driver mutations, interstitial lung disease, untreated diabetes, or missing data were excluded. We compared weight changes, progression-free survival (PFS), overall survival (OS), and adverse events between patients with and without SGLT2i. We defined cachexia as either 5% or more body-weight loss within six months prior to the initiation of lung cancer treatment or weight loss greater than 2% and a body-mass index (BMI) of less than 20 kg/m2.

Results

Eighteen patients (21.9%) out of 82 received SGLT2i for diabetes. There was no difference in the incidence of cachexia between the two groups (66.7% vs. 46.9%, p = 0.184), despite significant weight loss in the SGLT2 group compared to the non-SGLT2 group (median − 5.8% vs. − 3.4%, p = 0.039). No significant differences were observed in progression-free survival (PFS) (median 6.2 vs. 4.1 months, p = 0.512) or overall survival (OS) (median 11.9 vs. 14.6 months, p = 0.583). Grade ≥ 3 adverse events occurred in 11.1% of patients in the SGLT2i group and 31.2% of patients in the non-SGLT2i group (P = 0.132). There were no cases of diabetic ketoacidosis or urinary tract infections.

Conclusion

SGLT2 inhibitors were associated with weight loss and were not associated with worse survival or increased toxicity in this limited retrospective cohort.