To the Editor Arrieta and colleagues1 recently published an open-label randomized clinical trial (RCT) evaluating the addition of metformin to tyrosine kinase inhibitor (TKI) treatment in nondiabetic patients with non–small cell lung cancer carrying epidermal growth factor receptor (EGFR) variants. The authors reported significantly improved survival benefits without additional toxic effects. However, there are some major issues about this work that need to be addressed, especially considering that our larger-scale placebo-controlled double-blind RCT2 attempting to answer the same question had negative results.
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Gao C, Cai S, He Y. Metformin Plus Tyrosine Kinase Inhibitors in Epidermal Growth Factor Receptor–Mutated Non–Small Cell Lung Cancer. JAMA Oncol. 2020;6(5):782. doi:10.1001/jamaoncol.2020.0059
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