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Advanced Prostate Cancer
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STAMPEDE TRIAL K ARM METFORMIN PARTICIPANTS

The K Arm of the STAMPEDE TRIAL is looking at the effect on PSA, if any, of adding Metformin to ADT in non-diabetic PC men. I have seen a few posts on here from people who are taking part in that trial where the PSA seems to be coming / staying down, but I was wondering if there are a number of participants out there that could give us an idea informally, of how they are going with their PSA. The trial itself started in 2016 and won’t report until 2024, so any indications before then would be interesting to hear. If you respond can you give your pre-trial PSA, time on trial, and current PSA? Side effects would be of interest too. Thanks to any who respond.

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How would anyone know how they compare to standard-of-care alone, or if any PSA reduction is due to the metformin or the standard-of-care they are getting along with it (or both)? For example, what would it mean if I am taking metformin and docetaxel and my PSA goes down?

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As I understand it, the trial is SOC ADT vs SOC ADT + Metformin.

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Actually I stand corrected. Having just checked the STAMPEDE TrIal again I see that some participants may be having docetaxel as well. Nevertheless, the purpose of the trial is to determine the efficacy or not of adding Metformin to SOC treatment. So presumably they will separate the participants into groups with and without docetaxel. The results, as with the many arms of the STAMPEDE trial should be interesting to see.

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SOC not only includes docetaxel , but possibly Zytiga. I agree that the metformin results will be interesting, but we can't even get a hint until the trial is done. Meanwhile, there is a Canadian trial of metformin vs placebo in men on active surveillance with results expected sooner (2021).

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Thanks for your reply. Would you have a link to the Canadian study perchance?

I did check the STAMPEDE trial once again and while docetaxel is permitted, it doesn’t seem that zytiga is allowed. But it’s a mute point.

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They allow whatever is the Standard-of-care (SOC). Because both docetaxel and abiraterone are SOC now, people in the study will probably be taking one or the other.

I don't have the link handy. I'm sure you can find it on clinicaltrials.gov

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Metformin interferes with the MTOR metabolic pathway, which is associated with cancer proliferation.

The evidence to date suggests that prostate cancer patients live longer when they take metformin. The longer you take it the more it seems to help. PSA does not necessarily go down, but living longer is consistent with slowing the progression of the cancer.

I've been taking it for over 7 years. I'm not diabetic, I take it for cancer, with the knowledge and approval of my doctors. My PSA is terrible, but 12 years into this journey I just got a clean scan for bone metastases. Is it the metformin? No way to know, the n=1 problem. But I have no side effects of any kind from taking Metformin, and it is quite inexpensive. Why not try it? Why wait for a study to throw shade on the drug because it doesn't lower PSA? PSA is not cancer. My goal is to live a good life, PSA be damned.

ncbi.nlm.nih.gov/pmc/articl...

Margel et al. assessed the relation between duration of metformin therapy after prostate cancer diagnosis and mortality in patients with diabetes (59). The data were obtained from several databases in Ontario (Canada). In the cohort consisting of 3,837 patients, they noted that the longer duration of metformin treatment after diagnosis of prostate cancer was associated with a significant decrease not only in the risk of cancer-specific but also in all-cause mortality.

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Congratulations on your scan....My MO said the trials aren't completed so no....next stop, my PCP...I agree with your thoughts on this matter.... studies with diabetic men point that way...it may be a combo effect--extra control of sugar--decrease BS--starve the beast -and the MTOR pathway...one day they will know...

All the best

Fish

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FCoffey,

Did you have nicro mets lymph nodes at post pathology after RP? and what other treatments have you had salvage RT? -- what is your current PSA and treatment if you don't mind me asking.

Thanks,

George

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George,

You assume far too much, so I do mind. No hard feelings.

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Sorry, no problem, I thought we were all here to share our treatment / status / side effects / whats working or not for others to possibly benefit from.

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That's certainly one of the many good reasons to be here. I have some sensitivity about being interrogated in public. That's just me.

What is right for me has almost nothing to do with what is right for you. All of us face difficult decisions about quality of life and longevity. My answers to those questions will be different than yours, even if our diseases were identical - which we both know they are not.

Add in the fact that I'd have to write several paragraphs correcting your assumptions, and the near certainty of snark and worse from others (not you) because my choices are not the standard ones, I must politely decline.

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No one has any right to criticize your treatment choices I wouldn’t let that stop me. No one knows who you are or even where you live – you weren't being interrogated in public -- you have already told us unsolicited that you have had PCa for 12 years, – you take Metformin – your doctors approve – you don’t have diabetes – you have taken Metformin for 7 years, – your PSA is “terrible” – but won’t say what it is – you have N-1 but are highly sensitive to telling when the N-1 was detected – or if you had RP.

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2024..... Hmmmm

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/14/2019 7:54 PM EST

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Lol. That’s why it would be interesting to get some sort of indication of how it might be going from participants. It would be informal, not official, but hey why not? Cheers

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You have a point..... so do I, it's on my head....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/14/2019 8:42 PM EST

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