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.

中文翻译：

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表皮生长因子受体突变的非小细胞肺癌中的二甲双胍加酪氨酸激酶抑制剂。

致编辑Arrieta及其同事¹最近发表了一项开放标签的随机临床试验（RCT），该试验评估二甲双胍在酪氨酸激酶抑制剂（TKI）治疗中的非糖尿病非小细胞肺癌携带表皮生长因子受体（EGFR）的患者中的应用变体。作者报告说，在没有其他毒性作用的情况下，其生存获益显着提高。但是，有一些有关此工作的重大问题需要解决，尤其是考虑到我们试图回答同一问题的大规模安慰剂对照双盲RCT ²产生了负面结果。