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Does Lantus Cause Cancer?
Considering what I am about to write, I feel a little guilty about the post headline here. But these sensational headlines are just the point: the media is abuzz the last few days with the possibility that Lantus insulin “may be linked” to cancer.
The rumors started late last week, when the media got wind that a prominent diabetes 
researcher forecasted that an “earthquake” event was about to hit that would compromise the safety profile of Lantus. This leak came nearly two weeks before the data was actually published in the European journal Diabetologia.
For both academia and the pharma industry, a leak like this is just so irresponsible! Why? Because it kicks off just the kind of anti-Avandia media frenzy that frightens patients off their meds, without real substantiation of the potential danger. In this case, the research data wasn’t even out yet, and already headlines like mine, above, using the “C-word” (cause) were appearing far and wide.
Now that the data is actually out, there are a few
Important Things to Know About This Story:
1) No cause was shown! “There was no evidence that Lantus actually causes cancer, but it might possibly cause any existing cancer cells to grow and divide more rapidly,” according to Ulf Smith, president of the European Association for the Study of Diabetes (EASD).
2) Backing up for a moment, the study conducted here was not your usual kind, where one group takes the drug and another gets a placebo (unethical in a case like this, of course). Rather, researchers took recorded data (housed in databases) from 127,031 patients in the UK, Germany, Sweden and Scotland and “crunched the numbers” to look for associations with instances of cancer.
Given that it’s just a bunch of numbers correlating insulin use with a handful of different types of cancer, the data is pretty inconclusive. Even the American Diabetes Association has come out with a statement that “the data within these studies and between these studies are conflicting and confusing.”
3) The official recommendation to patients using Lantus now by the ADA and other expert groups is not to stop using insulin, and also to “consult your doctor” if you have concerns. I have to agree with the much-quoted diabetes analyst David Kliff that this approach is a bit lame.
That is, while I agree that it’s important for PWDs not to toss aside their insulin, I’d also like to know how the many physicians across this country are supposed to be prepared to consult with their diabetes patients when they’ve had no time to analyze the data? And how, after reading these confusing studies, can they effectively tell their patients anything other than “there might be a link between Lantus and cancer?”
4) As eloquently pointed out by Jenny over at Diabetes Update, the population studied was most likely a very high-risk group for cancer due to a number of other factors, leading with running consistently high blood sugars for many years — most likely long before being prescribed Lantus. Many had probably also been taking “cocktails of powerful oral drugs for years before starting Lantus.” Therefore, to pin the cancer correlation solely on Lantus insulin is probably misleading at best.
Nevertheless, Jenny concludes that “this latest alarm… is probably GOOD news, because it will trigger some serious research into the cancer profile of all the analog insulins and perhaps, even, of the oral diabetic drugs.”
Personally, my prediction is a bit different: I’m betting that after a lot of bantering about by various researchers and industry experts, we’ll end up with data illustrating a TINY risk in people who already had or are already very high-risk for cancer. Meanwhile, the damage has been done in the sense that people who really need it are afraid to take their insulin.
I say this even with the knowledge of new, more conclusive evidence that the oral drug Januvia may indeed spur pancreatic cancer.
When it comes to insulin, as long as the risk of side effects is tiny, which I’m assuming it will be, we patients will have to weigh the pros and cons: the consequences of not taking insulin when you need it are more immediately damaging, are they not?
Whether the cancer risk with Lantus proves significant or not, the scare is surely hurting drugmaker Sanofi-Aventis, which is not good for us either, in terms of rising price-points and possible curtailing of drug development.
*Sigh* In the end, it’s always the patients who suffer most.
Explore posts in the same categories: D-News Examined, Diabetes Product Parade, Products
“*Sigh* In the end, it’s always the patients who suffer most.”
I TOtally agree. It sucks ass, big time.
Technology can have it’s pitfalls, definitely.
Ha ha, captcha:
2)guiding bullitt
I say: Guiding Bullshit.
Posted by: CALpumper | June 28th, 2009 at 8:03 pm(just sayin’)
Hmmm interesting. I wish they wouldn’t introduce things like this until they are proven. Just throwing ideas like this casually around could cause mass panic and, you are right, at this point it is more dangerous to not take you Lantus.
Posted by: Shamae | June 28th, 2009 at 8:55 pmI THINK NOVO MAY BE BEHIND ALL THIS TO INCREASE THE SALE OF THEIR OWN BASAL INSULIN!
Posted by: Ben Smith | June 28th, 2009 at 11:47 pmAnd you did that exact same thing to me by using that headline. My heart is in my throat, my 11 year old type 1 sitting next to me – and I read this? you did the exact same thing you were accusing other people about. Totally irresponsible. I have lurked here for months, but I am honestly considering removing you from my reader. I did not need to start my day with information like that. Sensationalizing is tempting isn’t it – that’s why others do it, and you did it here.
Posted by: HeidiRenee | June 29th, 2009 at 4:56 amI guess this is a Your Diabetes May Vary thing in that I read Amy’s headline and thought, “Great Amy is writing on the Lantus thing! I will be able to read something with intelligent details, unlike everything else I have seen this week.”
She is in touch with what is in the news and does her homework. I like it when she does a Law and Order, you know, “Ripped Form the Headlines.” To me it is important for her to use similar headlines language so that those folks who may have heard something form someone, who also suggest that cinnamon maybe better than Lantus, and choose to Google Search can find Diabetes Mine along with the really crummy stories that use the same kind of language.
In point of fact all us DOC folks should use the similar headline and make similar points to help people find the idea that the short term consequences of not taking insulin are a lot more serious than possible long term colorations.
Readers will get information that looks past simplistic pabulum. This is why I have Amy in my reader. This is why I read here first. This is why I keep Diabetes Mine in my reader. This is why I recommend it to others.
Amy
Love Ya / Mean It
Bennet
Posted by: Bennet | June 29th, 2009 at 5:43 am@Heidi – there were literally DOZENS of media headlines last week on this topic. I did not make up the Lantus-cancer issue by any means. My intent with this post was to call attention to this HIGHLY PUBLICIZED issue, and then discuss intelligently — as Bennet notes.
@Bennet – Love Ya, too. Thank you for the wonderful endorsement! As you know, I’ve poured my heart & life into this blog. Your support is much appreciated!
Posted by: AmyT | June 29th, 2009 at 8:36 amGreat article Amy. I agree with everything you said.
I am a type 2 diabetic who has previously taken Avandia and am currently taking Lantus.
I have worked in drug development research for over 25 years. Nothing in this report should cause a panic, but it probably will. As for me, I will continue with my Lantus
Posted by: scottrr | June 29th, 2009 at 10:08 amI hope and pray this is not a panic generated situtation where some one intentionally is going to short-sell Sanofi-Aventis stock reaping huge profits. This seems to be the thing these days of late
Posted by: rdreese | June 29th, 2009 at 10:43 amYou are naive to believe anything the government tells you about Lantus or any other drug!
The drug tests are no longer conducted in Universities, they are conducted in drug company labs. Where does the money come from to finance the tests? From the drug companies! Do you know that there are 2 drug company lobbyists for every 1 Congressperson?
They are desperate to keep their hold on the treatment of chronic diseases. Click here to learn what happens to natural cures and treatments http://tw6.us/mq
Posted by: Bill | June 29th, 2009 at 11:45 amAmy- I work in the industry and heard about this last week through investors, who seemed to have some information, but nothing concrete, which didn’t stop any of them from crying that the sky was falling. It’s very sad to me that the motivation for their cries was money with absolutely NO discussion or consideration of impact to the patients. Thank you for being a voice of reason and an advocate for PWD.
Posted by: Michele | June 29th, 2009 at 1:48 pmGreat! What alternatives are there to Lantus?
Posted by: Kent | June 29th, 2009 at 3:20 pmI wonder if there is any info on the fast acting Insulin like Humalog and Apridra. Anyone want to take a guess as to which one might be the safest to take. I was on lantus for several years before my Omni-Pod.
Posted by: Jules | June 29th, 2009 at 3:47 pmI wonder what would happen to Sanofi-Aventis stock if there was a cure? That stock would plummet to nothing. When I first became a Type 1 diabetic I was told it would be cured in 20 years. 30 years later it is still non-existent. Stem cells look promising, but not if it effects stock prices.
Brian
Posted by: Brian | June 29th, 2009 at 6:28 pmThis new does not surprise me, sanofi also produced acomplia rimonabant, and it was retired from market after clinical trials proved it caused suicide in some patients in the UK. This company is a shame.
Posted by: George Chucky | June 29th, 2009 at 6:38 pmCurious Amy, after reading your column do you receive any financial support from Sanofi?
Take a closer look at Lantus and it’s affinity to the IGF-1 receptor, it’s over 600%, human insulin is 100%, most companies won’t even develop an insulin of its IGF-1 affinity is over 100%.
Posted by: Joe | June 30th, 2009 at 4:16 pmSeriously Joe?
Posted by: AmyT | June 30th, 2009 at 10:23 pmhttp://online.wsj.com/article/BT-CO-20090626-715846.html
Amy, what is your point with that link to WSJ?
Posted by: Hugo | July 1st, 2009 at 12:54 amI am curious of this artical that has been posted. My Mother has been using Lantus for almost 3 years. She was diagnosed with Pancreatic cancer recently. Is there a link??? I question that now.
Posted by: Harry Carmen | July 1st, 2009 at 7:22 am@Hugo – the WSJ article states: “Until further research becomes available, the EASD said people taking Lantus should continue to do so.” Their word, not mine, so no, I’m not on Sanofi’s payroll with this post, as @Joe implies.
Posted by: AmyT | July 1st, 2009 at 8:18 amWell consider the alternative of not taking any insulin I’d be dead long ago so thanks to insulin we all get to have this discussion (least those type 1s here) . I currently take lantus coming from NPH so switching back and forth is not that big of deal while this is sorted. I agree with this article that pushing this kind of info out for public consumption was unwise and will damage the drug maker regardless of case being proven false.
As for the person above whining about the headline, stop being so sensitive. Even the headline is “Does Lantus Cause Cancer?” not “Lantus Causes Cancer. . . You’re Doomed!!!” I think you shouldn’t be using the internet for anything medically related if you are that easily scared by what you find.
Posted by: MikeC | July 1st, 2009 at 11:07 amI have been taking Lantus for over five years. This past January, I was diagnosed with colon cancer at age 36 with no family history. Given my situation and the studies being published, my doctor has recommended that stop using Lantus and switch to NPH until we have more information. I took my last dose of Lantus this morning and I have to say it felt scary… I am in the middle of chemo now. I truly hope that Lantus had nothing to do with my cancer.
Posted by: Brian | July 1st, 2009 at 3:30 pmThere is an alternative to Lantus…Levemir. This is a basal insulin. Talk to your doctor. It works Great!!!! Why would you take an insulin that might have any possiblity of being linked with cancer when you don’t have to??? Isn’t that a no brainer?
Posted by: jan | July 1st, 2009 at 7:51 pmThere are other insulins out there that were proven safe and in no way linked to cancer – like Levemir and Novolin N – Levemir is not only safe but is also long acting once a day insulin.
Posted by: Jenna | July 2nd, 2009 at 3:00 amI am currently using Apidra in my insulin pump. I’m wondering, since Apidra is made by the same company as Lantus, and the scientific name sounds similar, if it might make sense to switch back to humalog? Anyone have any educated guessses?
Posted by: Jules | July 2nd, 2009 at 8:36 amBeing someone who is familiar with this situation, Novo is not responsible for these 4 studies – Novo Nordisk, in fact, were in no way affiliated with these studies. FYI, Novo Nordisk developed the molecule that became Lantus. but decided not to go forward with it because it has a very high IGF-1R affinity of 641 – Novo only develops insulin with affinity to bind to this receptor at or below the natural human insulin affinity of 100%. The theory is that the IGF affinity of 641% that Lantus has cause cell proliferation and can cause existing tumor to grow even more rapidly. Levemir has an IGF-1R affinity of 16%. Sanofi took the chance going forward with Lantus because they knew all along about the high IGF-1 receptor affinity and developed the drug anyway. While I agree patients should not go off their insulin, they also need to know the truth and in my opinion Levemir seems the much safer choice for a long-acting insulin.
Posted by: John P | July 2nd, 2009 at 5:03 pmThe alternative to Lantus is Levemir, a long-acting basal insulin you take in the evening that gives you 24 hour control. Some studies also show that Levemir causes less weight gain than Lantus does. Levemir has an IGF-1R affinity of 16% and Lantus has an IGF-1R affinity of 641% – the lower the affinity to this IGF-1R, the better.
The alternative to Apidra is Novolog or Humalog. Novolog has a lower IGF-1R affinity compared to Humalog and also has a more consistent peak time.
FYI.
Posted by: John P | July 2nd, 2009 at 5:09 pmthe very sad thing is: how many people died while Pfizer denied there was any problem with their oral anti diabetic agent, Rezulin (sp?) Money ALWAYS is the
Posted by: Susan | July 2nd, 2009 at 5:41 pmfirst concern of the Pharmaceutical companies.
Until the public is educated about the difference between correlation and cause this type of confusion will continue to exist. We’re already convinced that the correlation between high cholesteral and heart disease is biblical cause and effect. There is a difference between a “risk factor” and a causal event. Having a swimming pool is a risk factor for drowning. It doesn’t cause it. Spoons don’t make you fat.
In the end a more enlightened consumer who thinks skeptically and critically about the plethora of “research” that abounds is our only real solution.
Posted by: Steve | July 3rd, 2009 at 9:10 amWe in the academe, believe that Lantus (Glargine) really can cause cancer.
Posted by: Michel | July 4th, 2009 at 8:02 amIt does not look as if I should panic :http://www.youtube.com/watch?v=kOi2YmsekoE&feature=channel. Just like Scott, I’ll keep on going with lantus as usual.
Posted by: Jenny | July 8th, 2009 at 9:01 am@Brian sorry about your recent diagnosis. Unfortunately diabetics are at increased risk for breast, colon, pancreas cancer.
I have been a nurse for over 10 years and have worked extensively with managing diabetes.
Someone mentioned IGF-1 receptor affinity, while it is true that Lantus has a high affinity to this receptor, the big question is what does that mean to patient’s?
First of all there are three receptor chains IR (insulin receptor), IGF-1 (insulin like growth factor receptor 1), and IGF-2. These structural chains of IR and IGF-1 are very similar an almost identical. Any insulin will bind primarily to the insulin receptors and growth factors will bind to the growth factor receptors. There is very little binding of insulin to growth factor receptors and vice versa. Therefore if you understand this concept you will see that the high affinity of lantus means NOTHING in terms of activating and binding to the growth factor receptors. And it makes perfect sense to have a higher affinity to the growth factor receptors because it closely resembles the insulin receptors. It’s not rocket science people!!!! In 1999 the FDA requested sanofi-aventis to conduct clinical trials to answer the questions concerning high affinity to the growth factor receptors of lantus and its possible link to cancer development. A study was conducted and completed and is available for your review by Dr. Rosenstock 2009, which confirm that when compared to NPH (human insulin), Lantus has no new safety concerns.
The only way in human beings to explore a possible link between growth factor receptor high affinity and any possible link to cancer is to study patients with diabetic retinopathy. There is a link between growth factor receptor high affinity and an increase in diabetic retinopathy. So if you take patients who do not have cancer and they are diabetics you randomize them on Lantus or NPH and you monitor them for four years looking for any type of tumor growth malignant or benign, then you will have a real scientific trial comparing apples to apples (patients were from USA and Canada, both groups were similar in age duration of diabetes and all other things being equal). That was the design of the Rosenstock trial which results showed no new safety concerns with lantus. Lantus is the only insulin thus far with this type of long-term safety data specifically looking at cancer.
Posted by: Nurse Kenny | July 9th, 2009 at 9:33 pmOh yeah, Novo is NOT responsible. Doctor with Byetta is….. FYI
Posted by: Nurse Kenny | July 9th, 2009 at 9:35 pmi had problems the first and last week i used this crap..now 6 months later i have 2 big lumps …..i have had it with drug companmies using us a guinny pigs
Posted by: dave | July 12th, 2009 at 9:28 pmDoes anyone know the numbers for Humalog vs Novolog in regards to the IGF-1R affinity. I have a five year old on Humalog (just switched Lantus to Levemir) and want to know if it’s worth it to switch to Novolog. I called both companies and of course could not find out any information.
Posted by: Denice | July 14th, 2009 at 9:02 amNovolog (Aspart) has an affinity to the IGF-1 receptor of 81% versus Humalog (Lispro) at 156%.
Posted by: Maureen | July 15th, 2009 at 6:01 pmUnveliable guys…how can you guys blame on Novo? Why don’t you just look at the fact that this is the forth SA drug that has problems with patients’ health? Let the authorities decide about these findings and do not try confuse society about pharma companies’ interests.
Posted by: Peter | July 18th, 2009 at 1:08 amlisten to Maureen people!
Posted by: Malignant Molly | July 19th, 2009 at 10:50 amI have Fibromyalgia and my Dr. prescribed me Lantus, the smallest amount. I took it for 1 week and the pain from my Fibro. increased ten fold and my sugar didn’t come down. So what was his reaction? Double the dose! Needless to say I didn’t and am feeling a hell of a lot better and still looking for a Dr.
Posted by: RICHARD N. KEENE | July 21st, 2009 at 8:33 amI forgot to mention that I told Aventis of my problem and sent them the receipt and they promptly sent me a check for what it cost me. Does that tell you something? When did a drug company ever reimburse a customer when they complained about a product?
Posted by: RICHARD N. KEENE | July 21st, 2009 at 8:39 amI have diabetes and i Believe that an insulin pump is the best thing
Posted by: SomeOne | July 21st, 2009 at 12:44 pmanyone could possibly have and there ain’t no cancers
plus there is a new test product it acts like lantus but more healthy.
How about animal insulin? There are people who still take that and it is does not have IGF. YOu can get it from Canada, but ins. will not cover it most likely.
Posted by: Lucy | July 21st, 2009 at 11:49 pmOh poor Sanofi!!! They knew about the IGF-1 receptor before bringing Lantus to market. But all the can think about is $$$…
Posted by: josh | July 22nd, 2009 at 5:38 amThe public should be given all the relevant facts so they can make an informative decision when it comes to their treatment.
Levemir & Protaphane is an alternative to Lantus that is safer, less weight gain and better control.
I was curious about your reference to cancer and long-term high blood sugars readings. Has this link been confirmed? I am a participant in DCCT and EDIC clinical trials for many years and have never heard any discussion of such links. I would be grateful to know more about this.
Posted by: Clint | August 2nd, 2009 at 7:58 pmSloan Kettering took me off lantus….
Thought I’d mention that my healthy self was diagnosed with thyroid cancer at Sloan Kettering, the kingpins of all things cancer-related. Thyroid cnacer doesn’t run in my family, etc. They removed it this past April & I’m feeling great. They also immediately removed me off Lantus which I was taking for many many years because of the possible cancer connection. I don’t doubt conspiracy angles from either products; however thought I’d mention that Sloan advised against Lantus.
Posted by: Cate | September 14th, 2009 at 6:06 pmHi – I’ve had Type 1 for (gasp) 35 years & look & feel fantastic — a true poster child to remove the “Dis” from ability
Hi my name is Veronica and I am a diabetic. My doctor started me on Lantus over 3 years ago and guess what I had cancer and almost lost my life. I just found out yesterday that Lantus might be causing my seizures, and also many other painful side effects, how’s that! I am really angry! I have been going through hell for the past years; because of a drug that I believe is causing this. Money talks I guess. The drug companies are probably sitting there pretty while people like us are suffering, because of side effects that they conveniently forget to tell us. What a disgrace! I’ve worked all my life. I have never asked anyone for anything and now my life has been completely destroyed. I can’t work. I can’t function and instead of correcting the problems and facing the mess that has been created by the greedy drug companies they keep on passing out lies. We also have these people that are getting paid by the very people to push these lies and keep pushing the problem under the rug. What in God’s name is wrong with this picture? Ya and by the way it does make you feel great when you first start it. Wait a few months after taking it.
Posted by: Veronica | January 18th, 2010 at 4:59 pmThis is what you wrote back to me.{Author: Microsoft Points
Posted by: Veronica | January 25th, 2010 at 12:41 pmComment:
I don’t believe everything i read on the internet and i def don’t believe that lantus can cause cancer…}
Maybe you work for the drug company?
I don’t lie and I make a point of it! Maybe you should come visit me, so you can see first hand of the hell I go through on a daily basis. I challenge that and I also challenge the fact that you don’t know what the hell you are talking about!
Maybe you should see all the medical records that prove some of these things that I go through, so you can stop saying wonderful things about this synthetic man made drug to help us diabetics, perhaps you will able to sleep better at night?
Maybe you should start finding a solution to the problem instead of making accusations to people like us by calling us liars! You don’t know me!
Drug companies are getting quite fat with people like us that are sick and have to buy these expensive drugs. I heard that some of these drug companies pay some doctors to promote these drugs. The drug companies are getting richer while we are dying or going through hell. This is ok to you is it?
I’m worried. My doc ask me to change my Lantus to NPH just for precaution.
Posted by: Gustavo | February 2nd, 2010 at 2:09 pmGustavo,
Posted by: Veronica | February 4th, 2010 at 4:19 pmI feel very saddened that you are so worried. I hope that your own illnesses will soon get better. I was so angry when I wrote on this page on January 25th.
I am extremely angry with the media and the commercials that are pushing drugs on people like us. I take so many medications and I can’t seem to come to a happy place. I’m always in excruciating pain and the drugs make them worse or something else happens to me. Can you believe that the drug companies in many cases pay the doctors to push drugs on there patients. Some of these drugs have major side effects to some people and no one body is the same. We all have our own allergies to things and I don’t care about those people that have blinders on, because allot of these people don’t understand what we go through, because there simple goal is to make money. Shame on them for putting us through this and not trying to understand where we are coming from.
My prayers are with you. Stay safe, keep your diet and excercise and tell your doctor if you are taking vitamins, because some vitamins may have side effects to certain medications. Take care
Veronica