The Influence of Anti-Diabetic Drugs on Prostate Cancer

SIMPLE SUMMARY: A better understanding of the relation between two chronic diseases with high age-related incidence—prostate cancer (PC) and type 2 diabetes mellitus (T2DM)—seems to be crucial in a population with a growing life expectancy. In this review, a summary of the impact of widely used antidiabetic drugs on the risk of incidence and progression of PC is provided. This leads to the proposition that scientific efforts should potentially lead to the development of strategies with the most adequate treatment options of T2DM among patients with co-existing PC. Available data demonstrate that most antidiabetic drugs do not increase the risk during the treatment of patients with PC. Some reports show a potential advantage of treatment of T2DM with specific drugs. Conclusions revealed the need for further well-designed, laboratory and clinical investigations addressing the concerns raised in the issued articles. ABSTRACT: The incidences of prostate cancer (PC) and diabetes are increasing, with a sustained trend. The occurrence of PC and type 2 diabetes mellitus (T2DM) is growing with aging. The correlation between PC occurrence and diabetes is noteworthy, as T2DM is correlated with a reduced risk of incidence of prostate cancer. Despite this reduction, diabetes mellitus increases the mortality in many cancer types, including prostate cancer. The treatment of T2DM is based on lifestyle changes and pharmacological management. Current available drugs, except insulin, are aimed at increasing insulin secretion (sulfonylureas, incretin drugs), improving insulin sensitivity (biguanides, thiazolidinediones), or increasing urinary glucose excretion (gliflozin). Comorbidities should be taken into consideration during the treatment of T2DM. This review describes currently known information about the mechanism and impact of commonly used antidiabetic drugs on the incidence and progression of PC. Outcomes of pre-clinical studies are briefly presented and their correlations with available clinical trials have also been observed. Available reports and meta-analyses demonstrate that most anti-diabetic drugs do not increase the risk during the treatment of patients with PC. However, some reports show a potential advantage of treatment of T2DM with specific drugs. Based on clinical reports, use of metformin should be considered as a therapeutic option. Moreover, anticancer properties of metformin were augmented while combined with GLP-1 analogs.