Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Urology
  • Urology News
  • Can metformin delay...

Can metformin delay progression of prostate cancer? Study provides insights

Written By : Dr. Kamal Kant Kohli Published On 2023-11-10T18:30:06+05:30  |  Updated On 11 Nov 2023 10:43 AM IST
Can metformin delay progression of prostate cancer? Study provides insights
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

USA: A new study from Columbia researchers suggests that metformin is indeed a promising drug that could prevent the progression of prostate cancer, but only for tumours with low levels of NKX3.1, which are more likely to develop into aggressive cancers.

The researchers found that metformin restores cancer-fighting mitochondrial activity that is lost when NKX3.1 levels are low, prevents prostate cancer progression in mice, and is associated with better survival in patients with low-NKX3.1 tumours but not high-NKX3.1 tumours.

In the years since a 2005 study found that diabetes patients taking metformin had lower rates of cancer, oncologists have been excited by the prospect of using the inexpensive, safe, and widely used diabetes drug to prevent or slow the development of many cancers.

However, in studies of prostate cancer, metformin performance has been mixed, with some studies reporting a lower incidence of prostate cancer among men using metformin and others finding no relationship.

“Where we see metformin having the biggest impact is in patients who’ve just been diagnosed with prostate cancer,” says Alex Papachristodoulou, PhD, associate research scientist, who conducted the research in the lab of Cory Abate-Shen, PhD, chair of the Department of Molecular Pharmacology & Therapeutics.

Most patients with new diagnoses of prostate cancer have low-grade tumours that are not treated and are instead monitored by active surveillance. However, some of these tumours will become more aggressive and potentially life-threatening.

“Metformin could be given to patients under surveillance with high-risk tumours when there’s still time to prevent progression to advanced disease,” Abate-Shen says.

“Until this study no one understood this essential aspect of metformin and which patients could benefit,” says Columbia oncologist Mark Stein, M.D., who is helping design a clinical trial to test the idea in newly diagnosed patients but was not involved in the new study.

“The new work reinvigorates the idea of using this safe and inexpensive drug in a way that could benefit prostate cancer patients, potentially sparing them from additional treatment, and allows us to test the drug in a more focused way.”

The mitochondria connection

The idea to test metformin and its interaction with NKX3.1 developed from Papachristodoulou and Abate-Shen’s previous study, which revealed how low levels of the protein promote prostate cancer.

Low levels of NKX3.1 have been linked with aggressive disease for years, but it was unclear why the deficiency drove cancer development. Papachristodoulou and Abate-Shen found that when prostate cells are under oxidative stress (as happens during prostate cancer development), NKX3.1 moves into the cells’ mitochrondria to reduce the stress and protect the cells. If NKX3.1 levels are low, less protection is available, and prostate cells are more likely to turn malignant.

“That’s when we realized how metformin might be able help, since metformin is known to act on the mitochondria,” Papachristodoulou says.

In mice and men, metformin slows prostate cancer

To test metformin’s effect on low-NKX3.1 prostate cancers, the researchers gave metformin to low-NKX3.1 mice that tend to develop prostate cancer.

“These mice mimic the progression from lower- to higher-grade prostate cancer, similar to the cancers found in men who are put on active surveillance,” Papachristodoulou says, “but with metformin, we were able to stop further progression of the cancer.”

The researchers then looked at human prostate cancer cells and tissues, confirming that metformin works on the same mitochondrial processes in people and prevents further cancerous changes.

“The work was very elegant,” says Stein. “The models they have developed to understand the disease were key to answering the question. And to find a whole new mechanism of action for a drug that’s so ubiquitous is very unusual.”

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.

Potential to help reduce prostate cancer disparities

Papachristodoulou and Abate-Shen are now working with Stein, McKiernan, Loda, and others to set up a clinical trial to test if metformin can prevent the progression of prostate cancer in men with newly diagnosed, low-NKX3.1 tumors who are under active surveillance.

NKX3.1 levels are not typically measured in men newly diagnosed with prostate cancer, but based on the two cohorts examined, about 50% to 60% of patients may have low expressing NKX3.1 tumors.

Metformin could be particularly helpful for Black men, Papachristodoulou says, because they are more likely than white men to develop aggressive prostate cancer. “Though some of the health disparities are due to socioeconomic and health care inequities, we think there are biological factors like differences in NKX3.1 levels and mitochondria that also contribute,” Papachristodoulou says.

Along with studies to find additional biomarkers that identify patients with the greatest risk of developing aggressive prostate cancer, Papachristodoulou will continue to pursue disparities research in the Abate-Shen lab and his future independent career, with the help of a new K99/R00 grant he received last month.

Mitochondria, he thinks, may provide some answers.

“The search for biomarkers that can predict prostate cancer development and progression has largely focused on the nuclear genome, overlooking the mitochondrial genome,” he says, “but we know that alterations in mitochondrial genes are associated with lethal prostate cancer, particularly in Black men. I’m hoping that with the new grant, I’ll be able to identify more mitochondrial-related biomarkers like NKX3.1 and we can ultimately improve survival.”

References: Alexandros Papachristodoulou a b †, Isabel Heidegger c, Renu K. Virk b d, Matteo Di Bernardo a, Jaime Y. Kim a, Caroline Laplaca a e, Florencia Picech a, Georg Schäfer f, Guarionex Joel De Castro b e, Hanina Hibshoosh b d, Massimo Loda g, Helmut Klocker c, Mark A. Rubin h, Tian Zheng i, Mitchell C. Benson e, James M. McKiernan b e, Aditya Dutta a † ‡, Cory Abate-Shen a b DOI 10.1016/j.eururo.2023.07.016

European UrologyDiabetesprostate cancercancermetformin
Source : European Urology
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

Show Full Article
Next Story

Editorial

Featured image representing medico legal

What's the Role of Expert Opinion in Medical Negligence?

7- Point Discharge Protocol for AECOPD: Time to Inculcate in Practice

7- Point Discharge Protocol for AECOPD: Time to Inculcate in Practice

Aspirin Use in Women Aged 40-50 with Diabetes and Hypertension: Identifying the Ideal Candidates

Aspirin Use in Women Aged 40-50 with Diabetes and Hypertension: Identifying the Ideal Candidates

Darbapoetin Alfa In Chemotherapy Induced Anaemia: Check out 5 takeaways from recent study

Darbapoetin Alfa In Chemotherapy Induced Anaemia: Check out 5 takeaways from recent study

Biosimilar Denosumab of Alkem (Denuril) shows Comparable Efficacy in Treating Postmenopausal Osteoporosis in Indian Women

Biosimilar Denosumab of Alkem (Denuril) shows Comparable Efficacy in Treating Postmenopausal...

View All

Journal Club Today

Medical Journalism: Need of the Hour - Ft: Dr Prem Aggarwal (Chairman, Medical Dialogues), Dr Nandita Mohan (Head, MDTV Division, Medical Dialogues)

Medical Journalism: Need of the Hour - Ft: Dr Prem Aggarwal (Chairman, Medical Dialogues), Dr...

View All

Health News Today

Health Bulletin 08/ May/ 2025

Health Bulletin 08/ May/ 2025

View All
© 2022 All Rights Reserved.
Powered By: Hocalwire
X
We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok