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

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: . 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.