Enzalutamide Plus Metformin Versus Enzalutamide Alone in Metastatic Castration-resistant Prostate Cancer: A Randomized Phase 2 Trial (SAKK 08/14) - PubMed
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- #metformin
- #enzalutamide
- #prostate cancer
- Study compared enzalutamide plus metformin versus enzalutamide alone in metastatic castration-resistant prostate cancer (mCRPC).
- Primary endpoint was disease-control rate (DCR) at 15 months; no significant difference was found between the two groups (52% vs 56%, p = 0.64).
- Post hoc analysis suggested metformin may improve time to PSA progression (TTPSAP) in patients with PTEN-expressing tumors (p = 0.0074).
- Overweight/obese patients (BMI ≥25 kg/m²) had better outcomes (DCR, OS, EFS, TTPSAP, TTRP) regardless of treatment (p < 0.009).
- Addition of metformin did not improve overall study endpoints, but PTEN status and obesity paradox warrant further investigation.