Like all of the other advanced prostate cancer treatments currently available, enzalutamide (Xtandi) lasts for a limited time. When Xtandi stops working we refer to this as developing resistance.
Because of the resistance Xtandi only extends the survival of prostate cancer patients by 4-6 months. Researchers used C4-2, CWR22Rv1 and LNCaP prostate cancer cell lines, as well as mice bearing CWR22Rv1 xenografts and either treated with enzalutamide or metformin alone or in combination. They found that metformin is capable of reversing enzalutamide resistance and restores sensitivity of CWR22Rv1 xenografts. They also showed that metformin alleviated resistance to enzalutamide by inhibiting EMT.
These findings suggest that the combination of metformin with enzalutamide could be a more efficacious therapeutic strategy for the treatment of castration-resistant prostate cancer. However, these findings need to be confirmed in a clinical trial with humans. Even though the trials are not yet done to confirm this finding in humans, you should still discuss the possibility of adding Metformin to your Xtandi protocol.
Cell Death Dis. 2017 Aug 24;8(8):e3007. doi: 10.1038/cddis.2017.417.
Joel T. Nowak, MA, MSW wrote this Post. Joel is the CEO/Executive Director of Cancer ABCs. He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer.