Knura Miłosz, Garczorz Wojciech, Borek Adam, Drzymała Franciszek, Rachwał Krystian, George Kurian, Francuz Tomasz
Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.
Cancers (Basel). 2021 Apr 12;13(8):1827. doi: 10.3390/cancers13081827.
The incidences of prostate cancer (PC) and diabetes are increasing, with a sustained trend. The occurrence of PC and type 2 diabetes mellitus (T2DM) is growing with aging. The correlation between PC occurrence and diabetes is noteworthy, as T2DM is correlated with a reduced risk of incidence of prostate cancer. Despite this reduction, diabetes mellitus increases the mortality in many cancer types, including prostate cancer. The treatment of T2DM is based on lifestyle changes and pharmacological management. Current available drugs, except insulin, are aimed at increasing insulin secretion (sulfonylureas, incretin drugs), improving insulin sensitivity (biguanides, thiazolidinediones), or increasing urinary glucose excretion (gliflozin). Comorbidities should be taken into consideration during the treatment of T2DM. This review describes currently known information about the mechanism and impact of commonly used antidiabetic drugs on the incidence and progression of PC. Outcomes of pre-clinical studies are briefly presented and their correlations with available clinical trials have also been observed. Available reports and meta-analyses demonstrate that most anti-diabetic drugs do not increase the risk during the treatment of patients with PC. However, some reports show a potential advantage of treatment of T2DM with specific drugs. Based on clinical reports, use of metformin should be considered as a therapeutic option. Moreover, anticancer properties of metformin were augmented while combined with GLP-1 analogs.
前列腺癌(PC)和糖尿病的发病率呈持续上升趋势。PC和2型糖尿病(T2DM)的发生率随着年龄增长而增加。PC发生与糖尿病之间的相关性值得关注,因为T2DM与前列腺癌发病率降低相关。尽管有这种降低,但糖尿病会增加包括前列腺癌在内的多种癌症类型的死亡率。T2DM的治疗基于生活方式改变和药物管理。目前可用的药物,除胰岛素外,旨在增加胰岛素分泌(磺脲类、肠促胰岛素药物)、改善胰岛素敏感性(双胍类、噻唑烷二酮类)或增加尿糖排泄(格列净类)。在T2DM治疗期间应考虑合并症。本综述描述了目前已知的常用抗糖尿病药物对PC发病率和进展的机制及影响的信息。简要介绍了临床前研究结果,并观察了它们与现有临床试验的相关性。现有报告和荟萃分析表明,大多数抗糖尿病药物在治疗PC患者期间不会增加风险。然而,一些报告显示使用特定药物治疗T2DM具有潜在优势。基于临床报告,应考虑将二甲双胍作为一种治疗选择。此外,二甲双胍与胰高血糖素样肽-1类似物联合使用时,其抗癌特性会增强。