{"id":8241,"date":"2024-11-04T10:22:23","date_gmt":"2024-11-04T10:22:23","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=8241"},"modified":"2025-06-20T08:49:36","modified_gmt":"2025-06-20T07:49:36","slug":"lba70-adding-metformin-to-androgen-deprivation-therapy-adt-for-patients-pts-with-metastatic-hormone-sensitive-prostate-cancer-mhspc-overall-survival-os-results-from-the-multi-arm-multi-stage","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2024\/11\/04\/lba70-adding-metformin-to-androgen-deprivation-therapy-adt-for-patients-pts-with-metastatic-hormone-sensitive-prostate-cancer-mhspc-overall-survival-os-results-from-the-multi-arm-multi-stage\/","title":{"rendered":"LBA70 Adding metformin to androgen deprivation therapy (ADT) for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC): Overall survival (OS) results from the multi-arm, multi-stage randomised platform trial STAMPEDE (2024)"},"content":{"rendered":"\n

Type of publication:<\/strong><\/p>\n\n\n\n

Conference abstract<\/p>\n\n\n\n

Author(s):<\/strong><\/p>\n\n\n\n

Gillessen S.; Murphy L.R.; James N.D.; Sachdeva A.; Attard G.; Jones R.J.; Adler A.; El-Taji O.; Varughese M.; Gale J.; Brown S.J.; Srihari N.N.; Millman R.; Matheson D.; Amos C.L.; Murphy C.; McAlpine C.; Parmar M.K.; Brown L.C.; Clarke N.<\/p>\n\n\n\n

Citation:<\/strong><\/p>\n\n\n\n

Annals of Oncology. Conference: ESMO Congress 2024. Barcelona Spain. 35(Supplement 2) (pp S1258-S1259), 2024. Date of Publication: September 2024.<\/p>\n\n\n\n

Abstract:<\/strong><\/p>\n\n\n\n

Background: Metformin is a widely used, well tolerated anti-diabetic agent. Several studies suggest metformin has anti-cancer activity in different malignancies, including prostate cancer. We hypothesised that metformin also reduces the development of ADT-induced metabolic adverse effects, possibly improving OS via these mechanisms. Method(s): Non-diabetic pts with mHSPC were randomly allocated 1:1 to standard of care (SOC) or SOC+metformin within STAMPEDE. SOC included ADT +\/- radiotherapy +\/- docetaxel +\/- androgen receptor pathway inhibitor (ARPI). The primary outcome was OS. Target hazard ratio (HR) 0.8 (92% power, 2.5% 1-sided significance). 7 subgroup analyses were pre-specified but not pre-powered. Result(s): 1874 pts with mHSPC were randomised Sep2016-Mar2023. Arms were well balanced: median age 69 years, IQR 63-73; median PSA 84ng\/ml, IQR 24-352; de novo 1758 (94%) vs relapsed 116 (6%). Planned SOC included 82% Docetaxel and 3% ARPI. After a median follow-up of 60 months, the HR for OS between arms was 0.91 (p=0.148; 95% CI 0.80-1.03). The median (95%CI) OS was 63 (58-69) and 69 (63-73) months in the SOC and SOC+metformin arms respectively. In patients with high versus low volume disease (CHAARTED def), HR was 0.79 (p=0.006; 0.66-0.93) and 1.0 (p=0.992; 0.79-1.26) respectively. The interaction p-value = 0.086. For progression-free survival: Overall HR was 0.92 (p=0.164; 0.81-1.04) with HRs of 0.76 (p=0.001; 0.64-0.89) and 1.10 (p=0.401; 0.88-1.37) in the high and low volume subgroups respectively, interaction p-value = 0.006. Metabolic parameters that improved significantly with metformin included reduced weight gain, fasting glucose, HbA1c and total and LDL cholesterol. Fewer patients developed a metabolic syndrome. Adverse events (AE) >=grade 3 were reported in 52% and 57% in the SOC and SOC+metformin arms, respectively; Gastrointestinal AEs increased with metformin. Conclusion(s): Metformin does not improve survival in unselected metastati<\/p>\n\n\n\n

Link to full-text<\/a> [no password required]<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): Gillessen S.; Murphy L.R.; James N.D.; Sachdeva A.; Attard G.; Jones R.J.; Adler A.; El-Taji O.; Varughese M.; Gale J.; Brown S.J.; Srihari N.N.; Millman R.; Matheson D.; Amos C.L.; Murphy C.; McAlpine C.;…<\/span><\/p>\n

Read more LBA70 Adding metformin to androgen deprivation therapy (ADT) for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC): Overall survival (OS) results from the multi-arm, multi-stage randomised platform trial STAMPEDE (2024)<\/span> ›<\/span><\/a><\/div>\n

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