Anticancer drugs effects on glucose metabolism

Class/AgentGlycaemiaHbA1cc-peptide/insulinMechanisms
Hormonal agents
- GnRH agonists (triptorelin, leuprorelin)
- Anti-androgens (cyproterone acetate, flutamide, bicalutamide, nilutamide)
↑ [73]↑ [78]Increased Ins-Res
Glucocorticoids (prednisone, prednisolone, methylprednisolone, dexamethasone)↑ [80, 81]↑ [67, 81]Increased Ins-Res
mTOR inhibitors (everolimus, sirolimus, temsirolimus)↑ [87]↑ [67]Increased Ins-Res
ICIs
- Anti-CTLA-4 antibodies (ipilimumab)
- PDL-1 inhibitors (atezolizumab, avelumab)
- PD-1 inhibitors (nivolumab, pembrolizumab)
↑ [89]↑ [89]↓ [89]Reduced IP/S
Somatostatin analogues (octreotide, lanreotide, pasireotide)↑ (pasireotide) [93]
↓ (octreotide) [94]
↑ [93]Reduced IP/S
Reduced GP/S
L-asparaginase↑ [95, 96]Reduced IP/S
Alkylating agents (cisplatin, carboplatin, oxaliplatin, cyclophosphamide, etc.)↑ [9799]↑ [67]Reduced IP/S*
Anti-microtubules (docetaxel, paclitaxel, vinorelbine, vincristine, etc.)↑ [97, 100]↑ [67]Reduced IP/S*
Antimetabolites (5-fluorouracil, gemcitabine, capecitabine, methotrexate, etc.)↑ [98, 101]↑ [67]↓ [101]Reduced IP/S*
Antracyclines (doxorubicin, epirubicin, etc.)↑ [97]Reduced IP/S*

indicates the uncertainty of the evidence on this item; GnRH: gonadotropin-releasing hormone; Ins-Res: insulin resistance; HbA1c: glycated haemoglobin; mTOR: mammalian target of rapamycin; ICIs: immune checkpoint inhibitors; CTLA-4: cytotoxic T-lymphocyte 4-antigen; PDL-1: programmed cell death ligand-1; PD-1: programmed cell death-1; IP/S: insulin production/secretion; GP/S: glucagon production/secretion