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Adding metabolic agents to prostate cancer therapy: Every rose has its thorn

      In constant efforts to improve the outcomes of patients with cancer, scientists frequently investigate old and commonly prescribed drugs for their potential antineoplastic features. For statins and metformin, two metabolic agents which are both often prescribed, these antitumour properties have been suggested in preclinical studies [
      • Kochuparambil S.T.
      • Al-Husein B.
      • Goc A.
      • Soliman S.
      • Somanath P.R.
      Anticancer efficacy of simvastatin on prostate cancer cells and tumor xenografts is associated with inhibition of Akt and reduced prostate-specific antigen expression.
      ,
      • Liu Q.
      • Tong D.
      • Liu G.
      • Gao J.
      • Wang L.A.
      • Xu J.
      • et al.
      Metformin inhibits prostate cancer progression by targeting tumor-associated inflammatory infiltration.
      ]. Recent phase 3 trials of androgen receptor signalling inhibitors may provide the opportunity to investigate these putative effects in patients with prostate cancer. In this issue of the European Journal of Cancer, two complementary retrospective studies report outcomes of the use of statins and metformin in patients treated in clinical trials with abiraterone acetate plus prednisone/prednisolone or placebo, and enzalutamide or placebo, respectively.
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