Evidence map›Paper›PMID 41930153›Full record

ArticleOncology research2026

The Effect of Metformin on Atezolizumab/Bevacizumab Treatment in Patients with Hepatocellular Carcinoma and Diabetes.

Andrea Dalbeni, Marco Vicardi, Leonardo A Natola, Alessandra Auriemma, Bernardo Stefanini, Caterina Vivaldi, Piera Federico, Andrea Polloni, Caterina Soldà, Lorenzo Lani and 24 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Oncology research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Andrea DalbeniUnit of General Medicine C, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy.
Marco VicardiUnit of General Medicine C, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy.
Leonardo A NatolaUnit of General Medicine C, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy.
Alessandra AuriemmaSection of Innovation Biomedicine-Oncology Area, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy.
Bernardo StefaniniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Caterina VivaldiUnit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Piera FedericoMedical Oncology Unit, Ospedale del Mare, Napoli, Italy.
Andrea PolloniOncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Caterina SoldàOncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.
Lorenzo LaniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Ingrid GarajováMedical Oncology Unit, University Hospital of Parma, Parma, Italy.
Stefano TamberiUnit of Oncology, Ospedale Santa Maria Delle Croci, Ravenna AUSL Romagna, Ravenna, Italy.
Stefania De LorenzoOncology Unit, Azienda USL Bologna, Bologna, Italy.
Fabio PiscagliaDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Vincenzo Di MariaUnit of General Medicine C, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy.
Gianluca MasiUnit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Sara LonardiOncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.
Giovanni BrandiDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Bruno DanieleMedical Oncology Unit, Ospedale del Mare, Napoli, Italy.
Franco TrevisaniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Gianluca Svegliati-BaroniLiver Injury and Transplant Unit, Polytechnic University of Marche, Ancona, Italy.
Laura SchiadaLiver Injury and Transplant Unit, Polytechnic University of Marche, Ancona, Italy.
Fabio MarraDipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy.
Claudia CampaniDipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy.
Ciro CelsaGastroenterology and Hepatology Unit, Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, University of Palermo, Palermo, Italy.
Giuseppe CabibboGastroenterology and Hepatology Unit, Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, University of Palermo, Palermo, Italy.
Mariangela BruccoleriDivision of Gastroenterology and Hepatology, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
Massimo IavaroneDivision of Gastroenterology and Hepatology, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
Leonardo StellaLiver Unit, CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Francesca R PonzianiLiver Unit, CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Tiziana PressianiHumanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Lorenza RimassaHumanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Francesco TovoliDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
David SacerdotiLiver Unit, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: The combination of atezolizumab plus bevacizumab (A+B) represents one of the standards first-line treatments for unresectable hepatocellular carcinoma (HCC). Metformin has garnered attention for its potential antitumour and immunomodulatory properties beyond glycaemic control. This study aimed to assess metformin's impact in patients with type 2 diabetes mellitus (T2DM) receiving A+B therapy. Methods: This retrospective analysis of a prospectively-maintained multicentre database included 523 patients with HCC treated with A+B from the ARTE (Atezolizumab-bevacizumab Real-life Experience for Treatment of Hepatocellular Carcinoma) dataset across 18 Italian centres (May 2020-January 2024). We evaluated objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and time to progression (TTP) using Cox regression analysis and Inverse Probability of Treatment Weighting (IPTW) to address confounding. Results: Among 523 patients, 341 (65.2%) did not have diabetes and 182 (34.8%) had T2DM. In the overall population, metformin showed no significant benefit for PFS (HR = 1.15, 95% CI [0.88-1.50], Conclusion: This study found no evidence of improved outcomes with metformin use in patients with HCC in particular with T2DM receiving A+B therapy. Routine metformin use should not be expected to enhance A+B efficacy based on current evidence.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBevacizumabCarcinoma, HepatocellularDiabetes Mellitus, Type 2Liver NeoplasmsMetforminAgedAntibodies, Monoclonal, HumanizedFemaleHumansHypoglycemic AgentsMaleMiddle AgedRetrospective StudiesAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabHypoglycemic AgentsMetforminatezolizumabbevacizumabHepatocellular carcinomaimmune checkpoint inhibitorsmetformintype 2 diabetes mellitus

Identifiers

PMID41930153
PMCPMC13040334

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.