Chong R William, Vasudevan Vijaya, Zuber Jeffrey, Solomon Solomon S
Division of Endocrinology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Pharmacology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
Division of Endocrinology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Pharmacology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Medicine (Endocrinology) and Research Service, Veterans Affairs Medical Center, Memphis, Tennessee.
Am J Med Sci. 2016 Apr;351(4):416-9. doi: 10.1016/j.amjms.2016.01.013. Epub 2016 Jan 29.
Prostate cancer and type 2 diabetes mellitus (DM2) are both common diseases found in the elderly male population. The diabetic drug, metformin, has been shown to have antineoplastic properties and demonstrated better treatment outcomes when used as adjuvant therapy in patients with breast cancer. The hormonally-sensitive cancer analogous to breast cancer in men is prostate cancer. We investigated improved survival, lower risks of recurrences, and lower, more stable levels of prostate-specific antigen (PSA) in patients with DM2 along with prostate cancer on metformin.
Patients with prostate cancer along with DM2 who remained on metformin were compared with controls who were not on metformin matched by age, weight, race and Gleason score cancer staging. The endpoints of our study included final PSA values, number of recurrences, metastases and number living for each group.
There were significantly fewer deaths (23% versus 10%), fewer recurrences (15% versus 8%), fewer metastases (5% versus 0%) and fewer secondary cancers (17% versus 6%) in the metformin group (P < 0.004). The final PSA value was lower in the metformin-treated group with a result approaching significance (P = 0.067). The primary treatments for prostate cancer (ie, surgery, radiation and androgen depletion) were found to be comparable in both the groups.
Our retrospective study shows that adjuvant metformin therapy leads to a better prognosis in prostate cancer. Not only are PSA levels controlled for several years but also there are significantly fewer cancer recurrences in metformin-treated patients. Overall, these results are promising and should be followed up with a prospective study to assess long-term survival.
前列腺癌和2型糖尿病（DM2）都是老年男性人群中的常见疾病。糖尿病药物二甲双胍已被证明具有抗肿瘤特性，并且在乳腺癌患者中用作辅助治疗时显示出更好的治疗效果。在男性中，与乳腺癌类似的激素敏感性癌症是前列腺癌。我们研究了二甲双胍治疗的DM2合并前列腺癌患者的生存率提高、复发风险降低以及前列腺特异性抗原（PSA）水平更低且更稳定的情况。
将继续服用二甲双胍的前列腺癌合并DM2患者与未服用二甲双胍的对照组进行比较，对照组在年龄、体重、种族和 Gleason 评分癌症分期方面进行匹配。我们研究的终点包括每组的最终 PSA 值、复发次数、转移情况和存活人数。
二甲双胍组的死亡人数（23%对10%）、复发次数（15%对8%）、转移情况（5%对0%）和继发性癌症（17%对6%）明显更少（P < 0.004）。二甲双胍治疗组的最终 PSA 值较低，结果接近显著性水平（P = 0.067）。发现两组前列腺癌的主要治疗方法（即手术、放疗和雄激素剥夺）具有可比性。
我们的回顾性研究表明，辅助二甲双胍治疗可使前列腺癌患者预后更好。二甲双胍治疗的患者不仅PSA水平能在数年中得到控制，而且癌症复发次数也明显更少。总体而言，这些结果很有前景，应该通过前瞻性研究进行随访，以评估长期生存率。
