CARING

CAncer Risk and INsulin analoGues

 Partecipanti

Mappa

 Word cloud

Esplora la "nuvola delle parole (Word Cloud) per avere un'idea di massima del progetto.

 Obiettivo del progetto (Objective)

'Several studies have linked the use of insulins to the risk of cancer, and it is certainly plausible that as a growth factor, exposure to administered insulin could stimulate neoplastic growth. However, the meta-analyses of randomized clinical trials comparing different insulin analogues were too small to quantify the risks, especially the proportion of patients that were followed for more than 6 months. Hence, the European Medicines Agency has requested urgent research to determine the risks of cancer for users of insulin and insulin analogues, and investigate possible mechanisms of cancer promotion. CARING will obtain precise data on the incidence of cancer in diabetic patients and determine any link with use of various insulin and insulin analogues. The study will utilise high quality prescription databases and other national datasources, integrated at European level with advanced methods of harmonising data. The study will take into account potential confounders. The project aims to determine the influence of drug dose on risk, and through a risk model, identify predictors of cancer for insulin users. A review of published evidence combined with a study of tumour characteristics and gene expression in breast cancer tumour collections will aid understanding of potential mechanisms of cancer initiation and/or promotion by insulin. The project consortium involves some of the most experienced pharmacoepidemiology groups in Europe, and a leading cancer research institute. The consortium will liaise closely with the European Medicines Agency and other stakeholders throughout the study.'

Introduzione (Teaser)

The use of insulin by diabetic patients has been linked with the emergence of cancer. A European study is examining the risks associated with insulin administration.

Descrizione progetto (Article)

Diabetes is caused by an inability to produce sufficient insulin, the hormone required to balance sugar levels in the blood, or because the body does not adequately respond to the insulin that is produced. Treatment of this metabolic disorder very often entails the lifelong administration of insulin or insulin analogues. However, a number of studies have highlighted the risk of cancer development in diabetic patients using insulin.

Meta-analyses of randomised clinical trials comparing different insulin analogues were too small to quantify the risks. As a result, the European Medicines Agency has urgently requested studies to investigate the risks of cancer in insulin users.

The EU-funded http://www.caring-diabetes.eu/ (CARING) (Cancer risk and insulin analogues) initiative essentially responds to this need. First, by reviewing clinical and published evidence on the risk of cancer associated with diabetes. Second, by performing a multi-country observational study assessing cancer risk with the use of insulin (analogues). Additionally they will elucidate the biological mechanisms responsible for the adverse effects of insulin administration. Scientists are also investing to identify potential co-founders which influence the association between insulin and cancer risk.

So far, the consortium has finalised protocols for studying (common study protocol) and analysing (common data model). Data were obtained from five different European countries (Denmark, Finland, the Netherlands, Norway, Sweden and the United Kingdom). These data sets will help portray the day-to-day assessment of dose and cumulative duration of insulin use. Breast cancer samples are also undergoing molecular analysis to provide gene expression and genetic profiling information.

The CARING project has already published various systematic reviews on risks of different cancer types in diabetic patients as well as the use of insulin and insulin analogues. Study outcomes will provide important new knowledge on the safety of diabetic medication and will help shape decisions concerning the future regulation of insulin use.