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This combination therapy involves the addition of the biguanide metformin to the standard-of-care regimen of docetaxel and prednisone for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Metformin, primarily used as an antihyperglycemic agent for type 2 diabetes, is investigated in oncology for its ability to activate AMP-activated protein kinase (AMPK), which subsequently inhibits the mTOR pathway and reduces circulating insulin and insulin-like growth factor 1 (IGF-1) levels—factors often associated with tumor progression. Docetaxel is a taxane chemotherapy agent that stabilizes microtubules, thereby inhibiting mitotic cell division and inducing apoptosis. Prednisone is a corticosteroid administered to mitigate the side effects of docetaxel and provide secondary hormonal therapy benefits. The New Mexico Cancer Research Alliance conducted a Phase II trial to evaluate whether this combination improves clinical outcomes and manages toxicity in patients with endocrine-resistant prostate cancer.
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