二甲双胍辅助治疗合并2型糖尿病的恶性肿瘤患者的专家共识（2022年版）

恶性肿瘤是近年来慢性非传染性疾病死亡的主要原因，也是影响人类预期寿命的最重要原因，其治疗效果差，预后不良。二甲双胍为2型糖尿病首选的降糖药物，其抗肿瘤的作用得到越来越多同行的认可。然而，目前国内外缺乏独立的临床指南、共识及大型前瞻性临床试验。本共识旨在为二甲双胍在抗肿瘤方面的临床应用提供参考。对于大多数合并2型糖尿病的恶性肿瘤患者，推荐联合使用二甲双胍治疗，可以辅助抗肿瘤及增强化疗药物敏感性，降低多种恶性肿瘤的发病率、转移率，从而降低死亡率;对于少部分合并2型糖尿病的恶性肿瘤患者，不推荐也不反对使用二甲双胍，如雌激素受体（estrogen receptor，ER）阴性或三阴性乳腺癌;对于大部分不合并糖尿病的恶性肿瘤患者，不推荐使用二甲双胍，如肺癌、结直肠癌、前列腺癌等;而对于极少部分不合并糖尿病的恶性肿瘤患者，在充分知情同意的情况下，可使用二甲双胍。

Expert consensus on metformin adjuvant therapy in malignant tumor patients with diabetes mellitus type 2 (2022 edition)

Malignant tumors are the leading causes of death from chronic non-communicable diseases and the most important factors influencing life expectancy in recent year, with poor treatment response and poor prognosis. Metformin, the preferred hypoglycemic drug for diabetes mellitus type 2, has been recognized by more and more peers for its anti-tumor effect. However, there is no independent clinical guideline, consensus and large prospective clinical trial at home and abroad. This expert guideline aimed to provide clinical practice reference for the application of metformin in anti-tumor treatment. This expert consensus recommends that metformin, used in combination for most malignancies with diabetes mellitus type 2, can assist in anti-tumor effect and enhance chemotherapeutic drug sensitivity, and reduce the morbidity and mortality of multiple malignancies. Metformin is not recommended or opposed for a small number of malignancies complicated with diabetes mellitus type 2, such as estrogen receptor (ER)-negative or triple-negative breast cancer. Metformin is not recommended for most malignant tumors without diabetes, such as lung cancer, colorectal cancer and prostate cancer. However, metformin can be used with informed consent in a very small number of malignancies without diabetes.