Metformin addition ruled out for nondiabetic men with metastatic CRPC
medwireNews: The outcomes of nondiabetic men with metastatic castration-resistant prostate cancer (CRPC) are not improved with the addition of metformin to docetaxel, finds the French TAXOMET trial.
Presenting the phase II results at the 2019 ASCO Annual Meeting in Chicago, Illinois, USA, Marc Pujalte-Martin (Centre Antoine Lacassagne, Nice) explained that metformin has been associated with a reduced risk for prostate cancer incidence and with improved outcomes in patients with prostate cancer and diabetes.
Therefore, there was rationale for using metformin in this population, but the results show “no meaningful clinical benefit,” he continued.
Outcomes were comparable regardless of whether participants received metformin 850 mg twice a day or placebo alongside docetaxel plus prednisone. For instance, the primary endpoint of a prostate-specific antigen response (≥50% decline) was achieved by 66% of the 47 men in the metformin group and by 63% of 48 men in the control group, while median progression-free and overall survival durations were 7.4 versus 5.6 months and 24.6 versus 19.7 months, respectively.
The incidence of adverse events was generally similar between arms, with the exception of all-grade diarrhea, which occurred at a rate of around 70% with metformin compared with approximately 50% in the placebo arm.
We await the results of the standard of care plus metformin arm of the STAMPEDE trial, which is investigating the combination in castration-sensitive disease, the presenter concluded.
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