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Metformin And Longevity (METAL)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02511665
Recruitment Status : Unknown
Verified July 2015 by Guy's and St Thomas' NHS Foundation Trust.
Recruitment status was:  Not yet recruiting
First Posted : July 30, 2015
Last Update Posted : July 30, 2015
King's College London
Information provided by (Responsible Party):
Guy's and St Thomas' NHS Foundation Trust

Brief Summary:
This is a randomized, placebo-controlled, double-blind, window of opportunity study investigating the biological mechanism of metformin in prostate cancer.

Condition or disease Intervention/treatment Phase
Prostate Cancer Drug: Metformin Radiation: PET-MRI Scan Drug: Placebo Phase 4

Detailed Description:

A potential role for metformin in prostate cancer has been suggested and given its wide availability, tolerable side effect profile and safety record it may represent a therapeutic option for men with prostate cancer. However, the mechanism of action by which metformin exerts its anti-cancer effect has yet to be fully characterised. This 'window of opportunity' trial provides an opportunity to investigate this by comparing baseline prostate biopsies with post-treatment surgical specimen by focussing on assessment of the FASN/AMPK axis.

Patients with newly-diagnosed, early stage, prostate cancer scheduled for radical prostatectomy will either enter the main study and be randomised 1:1 to receive metformin (2g daily over 2 divided doses; Arm A) or placebo four weeks prior to prostatectomy (standard of care; Arm B). Or a subset of five patients will enter the exploratory PET-MRI Substudy . These five patients will all receive metformin and will undergo an additional two PET-MRI Scans.

Prostate tissue (at baseline from biopsy and post treatment from prostatectomy) will be used for analysis of p-AMPK, p-ACC, FASN by immunohistochemistry and proliferation will be measured using Ki67 and TUNEL in both metformin and placebo groups.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 185 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Basic Science
Official Title: METformin And Longevity (METAL): A Window of Opportunity Study Investigating Biological Effects of Metformin in Localised Prostate Cancer
Study Start Date : July 2015
Estimated Primary Completion Date : July 2017
Estimated Study Completion Date : July 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Prostate Cancer

Arm Intervention/treatment
Experimental: Metformin
Metformin given , 1g twice a day for 4 weeks until prostatectomy +/- one week
Drug: Metformin
Given metformin
Other Name: Glucophage

Placebo Comparator: Placebo
placebo given , 1g twice a day for 4 weeks until prostatectomy +/- one week
Drug: Placebo
Given placebo

Experimental: PET-MRI
5 patients in this arm will all receive metformin and undergo two additional PET- MRI scans, one before and one after treatment
Radiation: PET-MRI Scan
Patients will under go 2 PET-MRI scans in the PET-MRI substudy arm one before treatment with metformin and one after

Primary Outcome Measures :
  1. Assessment of the difference in expression levels of markers of the FASN/AMPK pathway pre and post treatment between the placebo and metformin arms. [ Time Frame: 24 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Age 18 or older and willing and able to provide signed informed consent.
  2. Histologically confirmed adenocarcinoma of the prostate , with a minimum maximal tumour length of greater than 6mm on core biopsy
  3. No previous treatment for prostate cancer (including surgery, any hormone therapy, radiotherapy and cryotherapy)
  4. Prostate biopsy within 8 weeks from screening which contains sufficient material for baseline molecular marker assessment at Guy's and St Thomas' NHS Foundation trust..
  5. Radical prostatectomy is the scheduled treatment of choice
  6. Eastern Cooperative Oncology Group (ECOG) Performance status less than or equal to 0 or 1.
  7. Adequate organ function, defined as follows:

    • Haemoglobin >10.0g/dL
    • Absolute neutrophil count >1.5x109/L
    • Platelet count >100x109/L
    • Renal function, eGFR >60ml/min (calculated by Cockcroft Gault)
    • AST and/or ALT <2.5 x ULN
    • Total Bilirubin <1.5 x ULN
  8. Able to swallow the drug and comply with study requirements.

Exclusion Criteria:

  1. Patients with a current or historical diagnosis of type one or two Diabetes and/or have ever received metformin
  2. Patients with hypersensitivity to any of the components of Metformin or placebo tablet
  3. History of or conditions associated with lactic acidosis such as shock or pulmonary insufficiency, alcoholism (acute or chronic), and conditions associated with hypoxaemia
  4. Patients with chronic liver disease, severe cardiovascular impairment, cardiac failure, recent myocardial infarction, severe peripheral vascular disease or renal impairment (eGFR <60ml/min as measured by Cockcroft Gault)
  5. Patients with acute severe disorders, for example infections with fever, pancreatitis, trauma, dehydration or reduced diet (<1000kcal or 4200kJ per day)
  6. Other active malignancy over the last five years that has required systemic therapy, excluding:

    • Adjuvant therapy in the curative setting
    • Non-melanoma skin cancer
    • Superficial transitional cell carcinoma (CIS-T1)
  7. Current enrolment in an investigational drug or device study or participation in such a study within 30 days of signing consent.
  8. Any subjects who is able to father a child and does not agree to use barrier protection, in the form of a condom ,for the duration of the trial and for 16 weeks after the last study drug administration.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02511665

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United Kingdom
Guy's Hospital
London, United Kingdom, SE1 9RT
Contact: Danielle Crawley, MBBS    02071887904   
Sponsors and Collaborators
Guy's and St Thomas' NHS Foundation Trust
King's College London
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Principal Investigator: Sarah Rudman, MBBS BSc PhD Guy's and St Thomas NHS Trust
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Responsible Party: Guy's and St Thomas' NHS Foundation Trust Identifier: NCT02511665    
Other Study ID Numbers: METAL
First Posted: July 30, 2015    Key Record Dates
Last Update Posted: July 30, 2015
Last Verified: July 2015
Additional relevant MeSH terms:
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Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Prostatic Diseases
Hypoglycemic Agents
Physiological Effects of Drugs