Metformin seems to work, but for patients in active surveillance

[Maxone73]

cuimc.columbia.edu/news/dia...

maybe too late for mCRPC, but it could still be helpful

[Tall_Allen]

Another silly mouse study. Everything works in mice. Here's the story clinically so far:

prostatecancer.news/2018/03...

STAMPEDE will be definitive.

BTW- low NKX3.1 is extremely rare in PCa. Its presence is used in IHC to diagnose PCa.

[Maxone73 in reply to Tall_Allen]

Not totally based on mouse if you read the last part (even if retrospective studies are always tricky). Hopefully also their new models will prove to be accurate. But yes they implicitly admit that NKX3.1 is rare.

"Finally, with the help of long-standing clinical collaborators James McKiernan, Renu Virk, and Mitchell Benson at Columbia, Max Loda at Cornell, and others in Europe, the researchers retrospectively examined the effect of metformin in two groups of men who had been treated for prostate cancer. (Many men in both groups took metformin for their diabetes.)

After measuring NKX3.1 levels in tissue samples from the patients, researchers found that metformin only benefitted patients with low NKX3.1 levels and mitochondrial impairment. Remarkably, among men with low NKX3.1 cancers under active surveillance, those taking metformin (three out of three) had their cancers downgraded during the surveillance period, while three out of four patients who did not take metformin had their cancers upgraded."

[Tall_Allen in reply to Maxone73]

You can read in my article why retrospective studies of Metformin are useless.

[Maxone73 in reply to Tall_Allen]

Read it, the IMPROVE study was terminated as follows (if you want to update the links to the trials):

"Results:

169 pts were accrued from 06/2016 - 02/2021 in 15 Swiss centers. Median follow-up was 44 mos (95%CI 39.0-48.7). The primary endpoint was not met: DCR at 15 mos was 52.4% for ENZ + MF and 56.1% for ENZ, respectively (p=0.644). There was a trend towards improved median EFS for ENZ + MF vs ENZ (19.3 (12.5, 28.1) vs. 15.1 (12.1, 21.4) mos; HR 0.87 (95%CI 0.60-1.26; p = 0.471)), median TTPSAP (15.8 (11.4, 20.6) vs. 11.0 (9.4, 13.2) mos; HR 0.71 (95%CI 0.49-1.04; p = 0.074)) and median time to pain progression (41.7 (16.9, NA) vs. 20.3 (14.2, 58.4) mos, p = 0.474)). Median OS was similar in both arms (38.7 (25.9, 50.0) and 40.9 (28.3, 51.7) mos; HR 1.13 (0.74, 1.71); p = 0.575).

Conclusions

This is the first randomized study to investigate ENZ + MF in mCRPC and it was negative for the primary endpoint. However, MF may have a modest effect on PSA dynamics and symptom control. Larger studies are needed for confirmation."

[Maxone73 in reply to Tall_Allen]

Can interventional trials start at phase 3? I am looking for phase 2 of some trials that are in phase 3 but I cannot find them under the same name, maybe I should search using authors' names?

[Maxone73 in reply to Tall_Allen]

by the way, also SAKK 08/​15 - PROMET was terminated, did not meet the endpoints it seems

[Boywonder56 in reply to Tall_Allen]

Thanks ta ....i was on metformin for years b4 dx.....and here i am ...i thought it might have caused my apc.......or maybe it was the lil debbies...

[j-o-h-n]

It's Greek to me....... OPA!

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 11/07/2023 6:31 PM EST

[Kaliber in reply to j-o-h-n]

Omph pa ….. 😂

[j-o-h-n in reply to Kaliber]

Close..... you're not an honorary Greek yet..... but keep trying....

If we ever get 3 Greeks to meet, we'll have 4 Generals....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/13/2023 1:20 PM EST

[Kaliber in reply to j-o-h-n]

ooooooh …. My bad .. I thought it read “ geeks “ not gReek. Oooops. 😂😂😂

[j-o-h-n in reply to Kaliber]

Now ya cooking with sterno,,,,,the Greeks have a word for it (To).............

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/13/2023 7:56 PM EST

[Kaliber in reply to j-o-h-n]

yayahahahaya yayahahahaya I’ll bet … funny.

❤️❤️❤️

[EdBar]

I still take it per Snuffy Myers, prescribed it almost 9 years ago. It’s helped maintain a normal BMI, and if you look at his YouTube video on it, it takes long term usage to get a real benefit in regards to cancer. I’ve been on the Snuffy protocol for around 9 years now and I haven’t had another oncologist, even Sartor tell me to change a thing.

Ed

[addicted2cycling in reply to EdBar]

Dr. Onik prescribed 1,700mg/day of Metformin for me in 2015 following PCa diagnosis. I recently stopped the Metformin and replaced it with Berberine Phytosome. Both A1C and Cholesterol numbers improved.

[Kevinski65 in reply to addicted2cycling]

What is your A1c ? The reason I ask they’re getting ready to put me on metformin for insulin resistance.

[Kevinski65 in reply to Kevinski65]

I took it before and it caused bad nausea.

[addicted2cycling in reply to Kevinski65]

*Metformin Extended Release (MXR). Metformin XR has better gastrointestinal tolerability and fewer side effects as compared to Metformin IR* --- might you have been taking Immediate Release????

[addicted2cycling in reply to Kevinski65]

My A1C has always been upper level good but lowered using Berberine.

[Maxone73 in reply to addicted2cycling]

I had my A1C checked, it's fine, no problems with glcyemia...so I suppose that metformin lowers sugar and insulin to sub-normal levels? Could it be done with intermittent fasting for example?

[garyjp9 in reply to EdBar]

What dose do you take, Ed?

[EdBar in reply to garyjp9]

2000mg a day

[garyjp9 in reply to EdBar]

Thanks

[Kevinski65]

I thought metformin was for type 2 diabetes…

[addicted2cycling in reply to Kevinski65]

EdBar wrote -- " ................ I’ve been on the Snuffy protocol for around 9 years now ... "

Yes it is but I thought Dr. Snuffy Myers introduced his PROTOCOL for PCa Patients to help control the sugars even if not Type 2.

[Maxone73]

pubmed.ncbi.nlm.nih.gov/350...

but we are talking about modest effect and obese patients...

[fast_eddie]

We take metformin. Me and the mouse in my pocket. No I am not diabetic but my A1C was a tad high. Love me that metformin.

[Kevinski65]

I was taking it but got so nauseous that I thought it was all over.