Objective:

To systematically evaluate the impact of type 2 diabetes mellitus (T2DM) on the prognosis of immune checkpoint inhibitors (ICIs) treatment specifically in lung cancer patients.

Key Findings:

• Patients with T2DM receiving ICIs had poorer overall survival (OS) (HR = 1.49, 95%CI: 1.25-1.77, P < 0.00001) based on six studies involving 1,225 participants.
• Patients with T2DM had poorer progression-free survival (PFS) (HR = 1.38, 95%CI: 1.04-1.83, P = 0.03).
• Subgroup analyses showed consistent poorer OS in T2DM patients regardless of sample size or type of survival analysis.

Interpretation:

T2DM may negatively impact OS in lung cancer patients treated with ICIs, but findings are based on limited studies and require further validation to confirm their significance.

Limitations:

• Small number of included studies may limit the generalizability of the findings.
• Limited sample sizes across studies could affect the robustness of the results.
• Inherent bias risks due to retrospective designs may influence the outcomes.
• Heterogeneity of tumor types complicates the interpretation of results.
• Instability of PFS results suggests caution in drawing conclusions.

Conclusion:

Current evidence suggests a potential association between T2DM and poor OS in lung cancer patients treated with ICIs, but further large-scale, prospective studies are needed to confirm these findings and explore the role of glycemic control.