Meta-analysis: metformin added to ADT improves metabolic markers but not survival, per STAMPEDE-inclusive pooled data
Meta-analysis · Prostate Cancer Prostatic Dis · 2026-10-16. Number 4 in the UrologyWatch Top 5 for October 16, 2026.
Pooling six RCTs (2,415 patients, 78% from STAMPEDE), metformin plus ADT modestly reduced waist circumference, HbA1c, and fasting glucose at 12 months, while STAMPEDE itself showed no overall survival benefit (HR 0.91, p=0.15).
Why it matters: Clarifies that metformin may help offset ADT-associated metabolic syndrome but should not be used with an expectation of oncologic benefit.
Limitation: Oncologic outcomes derived predominantly from a single trial (STAMPEDE); effect sizes for some outcomes were small.
Source: Prostate Cancer Prostatic Dis · PubMed 42875601 · DOI 10.1038/s41391-026-01165-w
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