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Metformin Does Not Improve Survival in Men with Advanced Prostate Cancer but Helps with Side Effects

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Metformin Does Not Improve Survival in Men with Advanced Prostate Cancer but Helps with Side Effects

Metformin is a common medicine used for diabetes. Some studies suggested it might also have anticancer effects, including in prostate cancer. Researchers wanted to know if metformin could help men with metastatic hormone-sensitive prostate cancer (mHSPC) live longer when added to standard treatment.

A large phase 3 clinical trial, called STAMPEDE, tested this idea. Nearly 1,900 men with advanced prostate cancer who did not have diabetes took part. They were randomly assigned to receive standard treatment (hormone therapy with or without chemotherapy or newer hormone drugs) either alone or together with metformin.

After about 5 years of follow-up, survival was similar between the two groups. Men who received metformin lived for about 67 months, while those on standard treatment alone lived for about 62 months. This small difference was not statistically meaningful.

Although metformin did not improve survival, it did help reduce some of the unwanted effects of hormone therapy. Hormone therapy can cause weight gain, higher blood sugar, and changes in cholesterol. Men taking metformin had fewer of these metabolic side effects.

The most common side effect from metformin itself was diarrhea, and a small number of men had to stop treatment because of it. Serious side effects were similar in both groups.

This study shows that metformin is safe for men with prostate cancer and may help with side effects of hormone therapy, but it does not seem to extend life in men with advanced disease. Doctors may still consider metformin for its benefits on metabolism, especially in men at risk of diabetes, but it is not a cancer treatment on its own.

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