Exploration of Medicine

Table 1. Anticancer drugs effects on glucose metabolism

Class/Agent	Glycaemia	HbA1c	c-peptide/insulin	Mechanisms
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.)	↑ [97–99]	↑ [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^*

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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

Declarations

Acknowledgments

The authors gratefully acknowledge professor Giuliana Arcidiacono, English and Anglo-American language PhD., University of Catania, for the language revision of the manuscript.

Author contributions

AM wrote the first draft of the manuscript; PV, FM, RV, and LS wrote sections of the manuscript. All authors contributed to manuscript revision, read and approved the submitted version.

Conflicts of interest

Not applicable.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

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Availability of data and materials

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Funding

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