Association Between Insulin Resistance and Insulin-like Growth Factor-1 Levels with Chemotherapy Response and Disease Progression in Advanced Non-Small Cell Lung Cancer with EGFR Wild Type

Background: Insulin resistance (IR) and insulin-like growth factor-1 (IGF-1) are known to play crucial roles in tumor progression and chemoresistance in various malignancies. This study aimed to evaluate the association between insulin resistance and IGF-1 levels with chemotherapy response and disease progression in patients with advanced non-small cell lung cancer (NSCLC) with EGFR wild-type status. Methods: This analytic cross-sectional study included 80 patients with advanced NSCLC with EGFR Wild type receiving platinum-based chemotherapy. IGF-1 levels and HOMA-IR were measured before chemotherapy. Disease progression was evaluated radiologically according to RECIST 1.1 criteria. Chi-square tests and odds ratios were used to determine the association between insulin resistance, IGF-1 levels, and progression risk. Results: Patients with higher IGF-1 levels (>3115 ng/mL) had a significantly higher risk of disease progression compared to those with lower IGF-1 (OR 17.76; p=0.001). Insulin resistance (HOMA-IR >2.5) was also significantly associated with disease progression (OR 2.87; p=0.032). Both biomarkers were independently related to chemotherapy resistance and poor clinical outcomes. Conclusion: Elevated IGF-1 and insulin resistance were significantly associated with lung cancer progression and poor chemotherapy response in advanced NSCLC patients. These findings suggest that metabolic dysregulation may contribute to chemoresistance and could serve as a potential target for adjunctive therapy in NSCLC.