Metformin in Patients Initiating ADT as Prevention and Intervention of Metabolic Syndrome

NCT03031821 | Terminated Phase 3 DMC

• 1 other identifier: PRIME
• Study Type: interventional
• Target: 168
• Locations: 1 country
• Sites: 16

Brief Summary

This is a multi-centre, double-blind, randomized phase III trial comparing metformin to placebo in patients with advanced prostate cancer starting (or have recently started) androgen deprivation therapy (ADT).

Conditions

Prostate Cancer; Metabolic Syndrome

Keywords

Prostate Cancer; ADT; Metabolic Syndrome; Androgen Deprivation Therapy; Phase III; Phase 3; Randomized

Outcome Measures

Primary Outcomes (1)

• Proportion of participants who meet the diagnostic criteria for metabolic syndrome after 18 months of study treatment

  A diagnosis of metabolic syndrome will be made according to the harmonized definition of the metabolic syndrome as defined in the joint statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and the International Association for the Study of Obesity. A patient will be classified as having metabolic syndrome if he possesses ≥3 of the aforementioned criteria: Increased waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting blood glucose. The prevalence of metabolic syndrome at 18 months post randomization will be calculated and compared between treatment arms using the two-sample t-test.

  18 months

Secondary Outcomes (10)

• Proportion of participants who meet the diagnostic criteria for metabolic syndrome after 9 months of study treatment

  9 months

• Proportion of participants who meet the diagnostic criteria for metabolic syndrome after 12 months of study treatment

  12 months

• Proportion of participants who meet the diagnostic criteria for metabolic syndrome after 24 months of study treatment

  24 months

• Proportion of participants who meet the criteria of reduced high-density lipoprotein cholesterol assessed at 18 months of follow-up.

  18 months

• Proportion of participants who meet the criteria of elevated triglycerides assessed at 18 months of follow-up.

  18 months

Other Outcomes (19)

• Serum insulin levels assessed at 18 months of follow-up.

  18 months

• Insulin resistance assessed at 18 months of follow-up.

  18 months

• Time to re-initiation of androgen deprivation therapy (in the subset of patients receiving intermittent therapy)

  18 months

Study Arms (2)

Metformin

EXPERIMENTAL

Metformin 850 mg PO OD X 30 days, then 850mg PO BID for a total of 18 months

Drug: Metformin

Placebo

PLACEBO COMPARATOR

Placebo Oral Tablet 1 tablet (850mg) PO OD X 30 days, then 850mg PO BID for a total of 18 months

Drug: Placebo Oral Tablet

Interventions

Metformin DRUG

Metformin Duration: 18 months 850 mg PO OD x 30 days then 850 mg PO BID for duration

Metformin

Placebo Oral Tablet DRUG

Placebo Oral Tablet Duration 18 months 1 tablet (850 mg) PO OD x 30 days then 1 tablet PO BID for duration

Also known as: Placebo

Placebo

Eligibility Criteria

• Age: 18 Years+
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must fulfill all the following criteria to be eligible for admission to the study:
• Pathologically confirmed adenocarcinoma of the prostate
• Eligible for initiating androgen deprivation therapy with either:
• (Neo-)Adjuvant therapy for localized prostate cancer that is planned continuously for at least 9 months; or
• Metastatic disease: or
• Biochemical recurrence of prostate cancer as defined as EITHER:
• A rising PSA after prior curative intent surgical therapy (e.g., prostatectomy with or without adjuvant/ salvage radiotherapy). Since an absolute consensus for this value has not been established, if a rising PSA has been documented by at least two PSA values at least 2 weeks apart, the criteria for biochemical recurrence are deemed to have been met. Or,
• PSA ≥ 2ng/mL above their nadir if previously treated with definitive radiotherapy
• Serum testosterone \> 5nmol/L (except for participants who have already started androgen deprivation therapy (within no more than 45 days of commencing study treatment)).
• The choice of androgen deprivation therapy is at the investigators discretion but must include at minimum the use of luteinizing hormone-releasing hormone (LHRH) agonist/antagonist therapy. The addition of other hormonal agents (e.g., non-steroidal antiandrogens, abiraterone, enzalutamide, apalutamide) is allowed.
• The androgen deprivation therapy undertaken can be intermittent or continuous, but the treatment intent must be declared prior to randomization.
• Participant is able (e.g., sufficiently fluent) and willing to complete the quality of life questionnaires in either English or French. The baseline assessment must be completed within required timelines, prior to registration/randomization. Inability (lack of comprehension in English or French, or other equivalent reason such as cognitive issues or lack of competency) to complete the questionnaires will not make the participant ineligible for the study. However, ability but unwillingness to complete the questionnaires will make the participant ineligible.
• Participant consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each participant must sign a consent form prior to enrolment in the trial to document their willingness to participate.
• Participant must be accessible for treatment and follow up. Participants registered on this trial must be treated and followed at the participating centre. Investigators must assure themselves that the participants registered on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
• Protocol treatment is to begin within 7 working days of participant randomization.

You may not qualify if:

• Participants who fulfill any of the following criteria are not eligible for admission to the study:
• Prior androgen deprivation therapy within 12 months of enrolment (except for participants who have started androgen deprivation therapy within 45 days of commencing study treatment)
• Prior androgen deprivation therapy associated with definitive treatment is permitted, if it has been completed at least 12 months prior to enrolment (e.g., last injection or tablet taken 12 months prior to study enrolment)
• Participant that meet ≥ 1 of the Canadian Diabetes Association criteria for the diagnosis of diabetes within 28 days of enrolment:
• Fasting plasma glucose of ≥ 7mmol/L; or
• HbA1C ≥ 6.5%.
• Participant currently taking metformin (or other diabetic medications) or who have taken metformin (or other diabetic medications) within 28 days of enrolment.
• History of lactic acidosis or conditions that predispose to lactic acidosis:
• Impaired Renal Function (eGFR \<45mL/ minute/ 1.73 m\^2); or
• Liver disease, including alcoholic liver disease, as demonstrated by any of the following parameters:
• AST \> 1.8 x the upper limit of normal
• ALT \> 1.8 x the upper limit of normal
• Alkaline Phosphatase \>2x the upper limit of normal
• Serum total bilirubin \> 1.5x the upper limit of normal (except for participant with Gilbert's Disease who are eligible despite elevated serum bilirubin levels).
• Alcohol abuse (habitual intake of ≥ 3 alcoholic beverages per day) sufficient to cause hepatic toxicity; or

Sponsors & Collaborators

• Canadian Urologic Oncology Group: lead
• Prostate Cancer Canada: collaborator
• British Columbia Cancer Agency: collaborator
• BC Cancer Foundation: collaborator

Study Sites (16)

Tom Baker Cancer Centre

Calgary, Alberta, T2S 3C3, Canada

Location

Cross Cancer Institute

Edmonton, Alberta, T6G 1Z2, Canada

Location

Vancouver Prostate Centre

Vancouver, British Columbia, V5Z 1M9, Canada

Location

BC Cancer Agency - Vancouver Cancer Centre

Vancouver, British Columbia, V5Z 4E6, Canada

Location

Cancer Care Manitoba

Winnepeg, Manitoba, R3E 0V9, Canada

Location

Horizon Health Network

Saint John, New Brunswick, E3B 4R3, Canada

Location

Central Newfoundland Regional Health Centre

Grand Falls-Windsor, Newfoundland and Labrador, A2A 2E1, Canada

Location

Dr. H. Bliss Murphy Cancer Centre

St. John's, Newfoundland and Labrador, A1B 8V6, Canada

Location

Northeast Cancer Centre

Greater Sudbury, Ontario, P3E 5J1, Canada

Location

Sunnybrook Research Institue

Toronto, Ontario, M4N 3M5, Canada

Location

Princess Margaret Cancer Centre (Princess Margaret Hospital)

Toronto, Ontario, M5G 2M9, Canada

Location

CHU de Quebec - Universite Laval

Laval, Quebec, Canada

Location

Centre Hospitalier de L'Universite de Montreal (CHUM)

Montreal, Quebec, H2X 0A9, Canada

Location

McGill University Health Center-Cedar Cancer Center

Montreal, Quebec, H4A 3J1, Canada

Location

Ciusss-Chus

Sherbrooke, Quebec, J1H 5N4, Canada

Location

Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-Centre-du-Québec / Centre hospitalier régional

Trois-Rivières, Quebec, G8Z 3R9, Canada

Location

Related Publications (71)

• Canadian Cancer Society. Canadian Cancer Statistics 2015: Canadian Cancer Society; 2015 [Available from: http://www.cancer.ca/].

  BACKGROUND

• Crook JM, O'Callaghan CJ, Duncan G, Dearnaley DP, Higano CS, Horwitz EM, Frymire E, Malone S, Chin J, Nabid A, Warde P, Corbett T, Angyalfi S, Goldenberg SL, Gospodarowicz MK, Saad F, Logue JP, Hall E, Schellhammer PF, Ding K, Klotz L. Intermittent androgen suppression for rising PSA level after radiotherapy. N Engl J Med. 2012 Sep 6;367(10):895-903. doi: 10.1056/NEJMoa1201546.

  PMID: 22931259 BACKGROUND

• Hussain M, Tangen CM, Berry DL, Higano CS, Crawford ED, Liu G, Wilding G, Prescott S, Kanaga Sundaram S, Small EJ, Dawson NA, Donnelly BJ, Venner PM, Vaishampayan UN, Schellhammer PF, Quinn DI, Raghavan D, Ely B, Moinpour CM, Vogelzang NJ, Thompson IM Jr. Intermittent versus continuous androgen deprivation in prostate cancer. N Engl J Med. 2013 Apr 4;368(14):1314-25. doi: 10.1056/NEJMoa1212299.

  PMID: 23550669 BACKGROUND

• Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002 Dec 4;288(21):2709-16. doi: 10.1001/jama.288.21.2709.

  PMID: 12460094 BACKGROUND

• Malik S, Wong ND, Franklin SS, Kamath TV, L'Italien GJ, Pio JR, Williams GR. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation. 2004 Sep 7;110(10):1245-50. doi: 10.1161/01.CIR.0000140677.20606.0E. Epub 2004 Aug 23.

  PMID: 15326067 BACKGROUND

• Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, Rinfret S, Schiffrin EL, Eisenberg MJ. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010 Sep 28;56(14):1113-32. doi: 10.1016/j.jacc.2010.05.034.

  PMID: 20863953 BACKGROUND

• Solymoss BC, Bourassa MG, Campeau L, Sniderman A, Marcil M, Lesperance J, Levesque S, Varga S. Effect of increasing metabolic syndrome score on atherosclerotic risk profile and coronary artery disease angiographic severity. Am J Cardiol. 2004 Jan 15;93(2):159-64. doi: 10.1016/j.amjcard.2003.09.032.

  PMID: 14715340 BACKGROUND

• Miettola J, Niskanen LK, Viinamaki H, Sintonen H, Kumpusalo E. Metabolic syndrome is associated with impaired health-related quality of life: Lapinlahti 2005 study. Qual Life Res. 2008 Oct;17(8):1055-62. doi: 10.1007/s11136-008-9386-6. Epub 2008 Aug 31.

  PMID: 18759109 BACKGROUND

• Park SS, Yoon YS, Oh SW. Health-related quality of life in metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2005. Diabetes Res Clin Pract. 2011 Mar;91(3):381-8. doi: 10.1016/j.diabres.2010.11.010. Epub 2010 Dec 4.

  PMID: 21134699 BACKGROUND

• Ford ES, Li C. Metabolic syndrome and health-related quality of life among U.S. adults. Ann Epidemiol. 2008 Mar;18(3):165-71. doi: 10.1016/j.annepidem.2007.10.009.

  PMID: 18280918 BACKGROUND

• Nguyen PL, Alibhai SM, Basaria S, D'Amico AV, Kantoff PW, Keating NL, Penson DF, Rosario DJ, Tombal B, Smith MR. Adverse effects of androgen deprivation therapy and strategies to mitigate them. Eur Urol. 2015 May;67(5):825-36. doi: 10.1016/j.eururo.2014.07.010. Epub 2014 Aug 2.

  PMID: 25097095 BACKGROUND

• James ND, Sydes MR, Clarke NW, Mason MD, Dearnaley DP, Spears MR, Ritchie AW, Parker CC, Russell JM, Attard G, de Bono J, Cross W, Jones RJ, Thalmann G, Amos C, Matheson D, Millman R, Alzouebi M, Beesley S, Birtle AJ, Brock S, Cathomas R, Chakraborti P, Chowdhury S, Cook A, Elliott T, Gale J, Gibbs S, Graham JD, Hetherington J, Hughes R, Laing R, McKinna F, McLaren DB, O'Sullivan JM, Parikh O, Peedell C, Protheroe A, Robinson AJ, Srihari N, Srinivasan R, Staffurth J, Sundar S, Tolan S, Tsang D, Wagstaff J, Parmar MK; STAMPEDE investigators. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet. 2016 Mar 19;387(10024):1163-77. doi: 10.1016/S0140-6736(15)01037-5. Epub 2015 Dec 21.

  PMID: 26719232 BACKGROUND

• Mohler JL, Armstrong AJ, Bahnson RR, D'Amico AV, Davis BJ, Eastham JA, Enke CA, Farrington TA, Higano CS, Horwitz EM, Hurwitz M, Kane CJ, Kawachi MH, Kuettel M, Lee RJ, Meeks JJ, Penson DF, Plimack ER, Pow-Sang JM, Raben D, Richey S, Roach M 3rd, Rosenfeld S, Schaeffer E, Skolarus TA, Small EJ, Sonpavde G, Srinivas S, Strope SA, Tward J, Shead DA, Freedman-Cass DA. Prostate Cancer, Version 1.2016. J Natl Compr Canc Netw. 2016 Jan;14(1):19-30. doi: 10.6004/jnccn.2016.0004.

  PMID: 26733552 BACKGROUND

• Kylin E. Studien ueber das Hypertonie-Hyperglykaemie-Hyperurikaemiesydrom. Zentralblatt fuer Innere Medizin. 1923;44:105-27.

  BACKGROUND

• Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988 Dec;37(12):1595-607. doi: 10.2337/diab.37.12.1595.

  PMID: 3056758 BACKGROUND

• Kaplan NM. The deadly quartet and the insulin resistance syndrome: an historical overview. Hypertens Res. 1996 Jun;19 Suppl 1:S9-11. doi: 10.1291/hypres.19.supplementi_s9.

  PMID: 9240756 BACKGROUND

• Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes. 1992 Jun;41(6):715-22. doi: 10.2337/diab.41.6.715.

  PMID: 1587398 BACKGROUND

• Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97. doi: 10.1001/jama.285.19.2486. No abstract available.

  PMID: 11368702 BACKGROUND

• Tsai HK, D'Amico AV, Sadetsky N, Chen MH, Carroll PR. Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst. 2007 Oct 17;99(20):1516-24. doi: 10.1093/jnci/djm168. Epub 2007 Oct 9.

  PMID: 17925537 BACKGROUND

• Braga-Basaria M, Dobs AS, Muller DC, Carducci MA, John M, Egan J, Basaria S. Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy. J Clin Oncol. 2006 Aug 20;24(24):3979-83. doi: 10.1200/JCO.2006.05.9741.

  PMID: 16921050 BACKGROUND

• Cleffi S, Neto AS, Reis LO, Maia P, Fonseca F, Wroclawski ML, Neves M, Pompeo AC, Del Giglio A, Faria EF, Tobias-Machado M. [Androgen deprivation therapy and morbid obesity: do they share cardiovascular risk through metabolic syndrome?]. Actas Urol Esp. 2011 May;35(5):259-65. doi: 10.1016/j.acuro.2011.01.011. Epub 2011 Apr 2. Spanish.

  PMID: 21459486 BACKGROUND

• Morote J, Ropero J, Planas J, Celma A, Placer J, Ferrer R, de Torres I. Metabolic syndrome in patients with prostate cancer undergoing androgen suppression. Actas Urol Esp. 2014 Jun;38(5):285-9. doi: 10.1016/j.acuro.2013.09.008. Epub 2013 Dec 20. English, Spanish.

  PMID: 24360772 BACKGROUND

• Bosco C, Crawley D, Adolfsson J, Rudman S, Van Hemelrijck M. Quantifying the evidence for the risk of metabolic syndrome and its components following androgen deprivation therapy for prostate cancer: a meta-analysis. PLoS One. 2015 Mar 20;10(3):e0117344. doi: 10.1371/journal.pone.0117344. eCollection 2015.

  PMID: 25794005 BACKGROUND

• Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG, Venner PM, Quinney HA, Jones LW, D'Angelo ME, Wells GA. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2003 May 1;21(9):1653-9. doi: 10.1200/JCO.2003.09.534.

  PMID: 12721238 BACKGROUND

• Carmack Taylor CL, Demoor C, Smith MA, Dunn AL, Basen-Engquist K, Nielsen I, Pettaway C, Sellin R, Massey P, Gritz ER. Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients. Psychooncology. 2006 Oct;15(10):847-62. doi: 10.1002/pon.1023.

  PMID: 16447306 BACKGROUND

• Basaria S, Muller DC, Carducci MA, Egan J, Dobs AS. Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy. Cancer. 2006 Feb 1;106(3):581-8. doi: 10.1002/cncr.21642.

  PMID: 16388523 BACKGROUND

• Tsai HT, Keating NL, Van Den Eeden SK, Haque R, Cassidy-Bushrow AE, Ulcickas Yood M, Smith MR, Potosky AL. Risk of diabetes among patients receiving primary androgen deprivation therapy for clinically localized prostate cancer. J Urol. 2015 Jun;193(6):1956-62. doi: 10.1016/j.juro.2014.12.027. Epub 2014 Dec 15.

  PMID: 25524243 BACKGROUND

• Keating NL, Liu PH, O'Malley AJ, Freedland SJ, Smith MR. Androgen-deprivation therapy and diabetes control among diabetic men with prostate cancer. Eur Urol. 2014 Apr;65(4):816-24. doi: 10.1016/j.eururo.2013.02.023. Epub 2013 Feb 22.

  PMID: 23453420 BACKGROUND

• Cox ME, Gleave ME, Zakikhani M, Bell RH, Piura E, Vickers E, Cunningham M, Larsson O, Fazli L, Pollak M. Insulin receptor expression by human prostate cancers. Prostate. 2009 Jan 1;69(1):33-40. doi: 10.1002/pros.20852.

  PMID: 18785179 BACKGROUND

• Foretz M, Guigas B, Bertrand L, Pollak M, Viollet B. Metformin: from mechanisms of action to therapies. Cell Metab. 2014 Dec 2;20(6):953-66. doi: 10.1016/j.cmet.2014.09.018. Epub 2014 Oct 30.

  PMID: 25456737 BACKGROUND

• Bridges HR, Jones AJ, Pollak MN, Hirst J. Effects of metformin and other biguanides on oxidative phosphorylation in mitochondria. Biochem J. 2014 Sep 15;462(3):475-87. doi: 10.1042/BJ20140620.

  PMID: 25017630 BACKGROUND

• Pollak M. Overcoming Drug Development Bottlenecks With Repurposing: Repurposing biguanides to target energy metabolism for cancer treatment. Nat Med. 2014 Jun;20(6):591-3. doi: 10.1038/nm.3596. No abstract available.

  PMID: 24901568 BACKGROUND

• Pollak M. Potential applications for biguanides in oncology. J Clin Invest. 2013 Sep;123(9):3693-700. doi: 10.1172/JCI67232. Epub 2013 Sep 3.

  PMID: 23999444 BACKGROUND

• Martin-Montalvo A, Mercken EM, Mitchell SJ, Palacios HH, Mote PL, Scheibye-Knudsen M, Gomes AP, Ward TM, Minor RK, Blouin MJ, Schwab M, Pollak M, Zhang Y, Yu Y, Becker KG, Bohr VA, Ingram DK, Sinclair DA, Wolf NS, Spindler SR, Bernier M, de Cabo R. Metformin improves healthspan and lifespan in mice. Nat Commun. 2013;4:2192. doi: 10.1038/ncomms3192.

  PMID: 23900241 BACKGROUND

• Pollak MN. Investigating metformin for cancer prevention and treatment: the end of the beginning. Cancer Discov. 2012 Sep;2(9):778-90. doi: 10.1158/2159-8290.CD-12-0263. Epub 2012 Aug 27.

  PMID: 22926251 BACKGROUND

• Nobes JP, Langley SE, Klopper T, Russell-Jones D, Laing RW. A prospective, randomized pilot study evaluating the effects of metformin and lifestyle intervention on patients with prostate cancer receiving androgen deprivation therapy. BJU Int. 2012 May;109(10):1495-502. doi: 10.1111/j.1464-410X.2011.10555.x. Epub 2011 Sep 20.

  PMID: 21933330 BACKGROUND

• Venkateswaran V, Haddad AQ, Fleshner NE, Fan R, Sugar LM, Nam R, Klotz LH, Pollak M. Association of diet-induced hyperinsulinemia with accelerated growth of prostate cancer (LNCaP) xenografts. J Natl Cancer Inst. 2007 Dec 5;99(23):1793-800. doi: 10.1093/jnci/djm231. Epub 2007 Nov 27.

  PMID: 18042933 BACKGROUND

• Joshua AM, Zannella VE, Downes MR, Bowes B, Hersey K, Koritzinsky M, Schwab M, Hofmann U, Evans A, van der Kwast T, Trachtenberg J, Finelli A, Fleshner N, Sweet J, Pollak M. A pilot 'window of opportunity' neoadjuvant study of metformin in localised prostate cancer. Prostate Cancer Prostatic Dis. 2014 Sep;17(3):252-8. doi: 10.1038/pcan.2014.20. Epub 2014 May 27.

  PMID: 24861559 BACKGROUND

• Sherifali D, Nerenberg K, Pullenayegum E, Cheng JE, Gerstein HC. The effect of oral antidiabetic agents on A1C levels: a systematic review and meta-analysis. Diabetes Care. 2010 Aug;33(8):1859-64. doi: 10.2337/dc09-1727. Epub 2010 May 18.

  PMID: 20484130 BACKGROUND

• Bailey CJ, Turner RC. Metformin. N Engl J Med. 1996 Feb 29;334(9):574-9. doi: 10.1056/NEJM199602293340906. No abstract available.

  PMID: 8569826 BACKGROUND

• Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998 Sep 12;352(9131):854-65.

  PMID: 9742977 BACKGROUND

• Hong J, Zhang Y, Lai S, Lv A, Su Q, Dong Y, Zhou Z, Tang W, Zhao J, Cui L, Zou D, Wang D, Li H, Liu C, Wu G, Shen J, Zhu D, Wang W, Shen W, Ning G; SPREAD-DIMCAD Investigators. Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease. Diabetes Care. 2013 May;36(5):1304-11. doi: 10.2337/dc12-0719. Epub 2012 Dec 10.

  PMID: 23230096 BACKGROUND

• United Kingdom Prospective Diabetes Study 24: a 6-year, randomized, controlled trial comparing sulfonylurea, insulin, and metformin therapy in patients with newly diagnosed type 2 diabetes that could not be controlled with diet therapy. United Kingdom Prospective Diabetes Study Group. Ann Intern Med. 1998 Feb 1;128(3):165-75. doi: 10.7326/0003-4819-128-3-199802010-00001.

  PMID: 9454524 BACKGROUND

• United Kingdom Prospective Diabetes Study (UKPDS). 13: Relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ. 1995 Jan 14;310(6972):83-8.

  PMID: 7833731 BACKGROUND

• Hermann LS, Schersten B, Bitzen PO, Kjellstrom T, Lindgarde F, Melander A. Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. A double-blind controlled study. Diabetes Care. 1994 Oct;17(10):1100-9. doi: 10.2337/diacare.17.10.1100.

  PMID: 7821128 BACKGROUND

• Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, Fowler S; Diabetes Prevention Program Research Group. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005 Apr 19;142(8):611-9. doi: 10.7326/0003-4819-142-8-200504190-00009.

  PMID: 15838067 BACKGROUND

• Smith MR, Lee H, Nathan DM. Insulin sensitivity during combined androgen blockade for prostate cancer. J Clin Endocrinol Metab. 2006 Apr;91(4):1305-8. doi: 10.1210/jc.2005-2507. Epub 2006 Jan 24.

  PMID: 16434464 BACKGROUND

• Ma J, Li H, Giovannucci E, Mucci L, Qiu W, Nguyen PL, Gaziano JM, Pollak M, Stampfer MJ. Prediagnostic body-mass index, plasma C-peptide concentration, and prostate cancer-specific mortality in men with prostate cancer: a long-term survival analysis. Lancet Oncol. 2008 Nov;9(11):1039-47. doi: 10.1016/S1470-2045(08)70235-3. Epub 2008 Oct 3.

  PMID: 18835745 BACKGROUND

• Spratt DE, Zhang C, Zumsteg ZS, Pei X, Zhang Z, Zelefsky MJ. Metformin and prostate cancer: reduced development of castration-resistant disease and prostate cancer mortality. Eur Urol. 2013 Apr;63(4):709-16. doi: 10.1016/j.eururo.2012.12.004. Epub 2012 Dec 14.

  PMID: 23287698 BACKGROUND

• Margel D, Urbach DR, Lipscombe LL, Bell CM, Kulkarni G, Austin PC, Fleshner N. Metformin use and all-cause and prostate cancer-specific mortality among men with diabetes. J Clin Oncol. 2013 Sep 1;31(25):3069-75. doi: 10.1200/JCO.2012.46.7043. Epub 2013 Aug 5.

  PMID: 23918942 BACKGROUND

• Rothermundt C, Hayoz S, Templeton AJ, Winterhalder R, Strebel RT, Bartschi D, Pollak M, Lui L, Endt K, Schiess R, Ruschoff JH, Cathomas R, Gillessen S. Metformin in chemotherapy-naive castration-resistant prostate cancer: a multicenter phase 2 trial (SAKK 08/09). Eur Urol. 2014 Sep;66(3):468-74. doi: 10.1016/j.eururo.2013.12.057. Epub 2014 Jan 4.

  PMID: 24412228 BACKGROUND

• Johnson NP. Metformin use in women with polycystic ovary syndrome. Ann Transl Med. 2014 Jun;2(6):56. doi: 10.3978/j.issn.2305-5839.2014.04.15.

  PMID: 25333031 BACKGROUND

• Generali JA, Cada DJ. Metformin: prevention and treatment of antipsychotic-induced weight gain. Hosp Pharm. 2013 Oct;48(9):734-77. doi: 10.1310/hpj4809-734.

  PMID: 24421546 BACKGROUND

• Saylor PJ, Smith MR. Metabolic complications of androgen deprivation therapy for prostate cancer. J Urol. 2013 Jan;189(1 Suppl):S34-42; discussion S43-4. doi: 10.1016/j.juro.2012.11.017.

  PMID: 23234628 BACKGROUND

• Forslund K, Hildebrand F, Nielsen T, Falony G, Le Chatelier E, Sunagawa S, Prifti E, Vieira-Silva S, Gudmundsdottir V, Pedersen HK, Arumugam M, Kristiansen K, Voigt AY, Vestergaard H, Hercog R, Costea PI, Kultima JR, Li J, Jorgensen T, Levenez F, Dore J; MetaHIT consortium; Nielsen HB, Brunak S, Raes J, Hansen T, Wang J, Ehrlich SD, Bork P, Pedersen O. Disentangling type 2 diabetes and metformin treatment signatures in the human gut microbiota. Nature. 2015 Dec 10;528(7581):262-266. doi: 10.1038/nature15766. Epub 2015 Dec 2.

  PMID: 26633628 BACKGROUND

• Feig DS, Moses RG. Metformin therapy during pregnancy: good for the goose and good for the gosling too? Diabetes Care. 2011 Oct;34(10):2329-30. doi: 10.2337/dc11-1153. No abstract available.

  PMID: 21949224 BACKGROUND

• Brackett CC. Clarifying metformin's role and risks in liver dysfunction. J Am Pharm Assoc (2003). 2010 May-Jun;50(3):407-10. doi: 10.1331/JAPhA.2010.08090.

  PMID: 20452916 BACKGROUND

• Lipska KJ, Bailey CJ, Inzucchi SE. Use of metformin in the setting of mild-to-moderate renal insufficiency. Diabetes Care. 2011 Jun;34(6):1431-7. doi: 10.2337/dc10-2361. No abstract available.

  PMID: 21617112 BACKGROUND

• Inzucchi SE, Lipska KJ, Mayo H, Bailey CJ, McGuire DK. Metformin in patients with type 2 diabetes and kidney disease: a systematic review. JAMA. 2014 Dec 24-31;312(24):2668-75. doi: 10.1001/jama.2014.15298.

  PMID: 25536258 BACKGROUND

• Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr; International Diabetes Federation Task Force on Epidemiology and Prevention; Hational Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20;120(16):1640-5. doi: 10.1161/CIRCULATIONAHA.109.192644. Epub 2009 Oct 5.

  PMID: 19805654 BACKGROUND

• Canadian Diabetes Association Clinical Practice Guidelines Expert Committee; Goldenberg R, Punthakee Z. Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes. 2013 Apr;37 Suppl 1:S8-11. doi: 10.1016/j.jcjd.2013.01.011. Epub 2013 Mar 26. No abstract available.

  PMID: 24070969 BACKGROUND

• Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993 Mar 3;85(5):365-76. doi: 10.1093/jnci/85.5.365.

  PMID: 8433390 BACKGROUND

• Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud'Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D'Angelo ME. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol. 2009 Jan 20;27(3):344-51. doi: 10.1200/JCO.2007.15.4963. Epub 2008 Dec 8.

  PMID: 19064985 BACKGROUND

• Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985 Sep;10(3):141-6.

  PMID: 4053261 BACKGROUND

• Rosenberg DE, Norman GJ, Wagner N, Patrick K, Calfas KJ, Sallis JF. Reliability and validity of the Sedentary Behavior Questionnaire (SBQ) for adults. J Phys Act Health. 2010 Nov;7(6):697-705. doi: 10.1123/jpah.7.6.697.

  PMID: 21088299 BACKGROUND

• Antuna-Puente B, Disse E, Rabasa-Lhoret R, Laville M, Capeau J, Bastard JP. How can we measure insulin sensitivity/resistance? Diabetes Metab. 2011 Jun;37(3):179-88. doi: 10.1016/j.diabet.2011.01.002. Epub 2011 Mar 23.

  PMID: 21435930 BACKGROUND

• Borai A, Livingstone C, Kaddam I, Ferns G. Selection of the appropriate method for the assessment of insulin resistance. BMC Med Res Methodol. 2011 Nov 23;11:158. doi: 10.1186/1471-2288-11-158.

  PMID: 22112229 BACKGROUND

• Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, Quon MJ. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000 Jul;85(7):2402-10. doi: 10.1210/jcem.85.7.6661.

  PMID: 10902785 BACKGROUND

• Riediger ND, Clara I. Prevalence of metabolic syndrome in the Canadian adult population. CMAJ. 2011 Oct 18;183(15):E1127-34. doi: 10.1503/cmaj.110070. Epub 2011 Sep 12.

  PMID: 21911558 BACKGROUND

• Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998 Jan;16(1):139-44. doi: 10.1200/JCO.1998.16.1.139.

  PMID: 9440735 BACKGROUND

• Roy S, Malone S, Grimes S, Morgan SC. Impact of Concomitant Medications on Biochemical Outcome in Localised Prostate Cancer Treated with Radiotherapy and Androgen Deprivation Therapy. Clin Oncol (R Coll Radiol). 2021 Mar;33(3):181-190. doi: 10.1016/j.clon.2020.09.005. Epub 2020 Sep 29.

  PMID: 32994091 DERIVED

MeSH Terms

Conditions

Prostatic Neoplasms; Metabolic Syndrome

Interventions

Metformin

Condition Hierarchy (Ancestors)

Genital Neoplasms, Male; Urogenital Neoplasms; Neoplasms by Site; Neoplasms; Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Prostatic Diseases; Male Urogenital Diseases; Insulin Resistance; Hyperinsulinism; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

Biguanides; Guanidines; Amidines; Organic Chemicals

Study Officials

• Bernie Eigl, MD

  British Columbia Cancer Agency

  STUDY CHAIR

• Nawaid Usmani, MD

  University of Alberta

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 20, 2017
• First Posted: January 26, 2017
• Study Start: July 12, 2018
• Primary Completion: November 24, 2023
• Study Completion: November 24, 2023
• Last Updated: October 4, 2024

Record last verified: 2024-10

Locations

CA (16)