According to new research, a common drug used to treat type 2 diabetes may have unexpected potential in the fight against prostate cancer. The drug pioglitazone appears to reprogram the metabolism of cancer cells, essentially starving to death the energy they need to reproduce and spread.
Scientists from an international team, including researchers from Umeå University in Sweden, found that patients with diabetic prostate cancer treated with pioglitazone performed well during the study period.
“This is a major finding. Our first clinical observations show that during the period of our focus, prostate cancer patients receiving drugs targeting proteins received drugs targeting proteins.”
How diabetes drugs fight cancer
The drug works to target a protein called PPARγ (a receptor gamma activated by peroxisome proliferators), which plays a crucial role in the diabetes and cancer pathways. Pioglitazone belongs to a class of drugs called thiazolidinediones (TZDS) that synthesize insulin sensitizers.
When applied to prostate cancer cells in laboratory studies, pioglitazone not only slows down its growth, but also fundamentally changes its metabolism. This metabolic reprogramming ultimately reduces the cancer cell’s ability to produce energy and limits its ability to migrate through tissues, potentially limiting metastasis.
Major findings from the study
- Pioglitazone significantly reduces prostate cancer cells in laboratory tests
- Drugs reduce tumor growth in animal models of metastatic prostate cancer
- Patients with diabetic prostate cancer who received PPAR agonists did not have biochemical recurrence during the study period
- Drugs change the main metabolic pathways in cancer cells and reduce energy production
- Treatment promotes more favorable “epithelial” cell characteristics in primary prostate cancer cells
What makes this finding particularly interesting is the dual nature of the relationship between diabetes and prostate cancer. While some studies suggest that diabetes may reduce the risk of prostate cancer, others have shown contradictory data, especially regarding the survival rate of cancer that does develop.
From bench to bedside: clinical significance
The team examined data from 69 prostate cancer patients who underwent major prostatectomy (surgical removal of prostate) between 2014 and 2023. Among these patients, patients who received PPAR agonists such as pioglitazone showed no signs of biochemical recurrence, a sign of biochemical recurrence, a key indicator of cancer.
Can this drug, designed specifically for diabetes, become a regular part of prostate cancer treatment? Researchers are cautiously optimistic, but emphasize that more work is needed.
“These findings are very promising, but further clinical studies are needed to confirm the results and study whether the treatment can also be used in prostate cancer patients without diabetes,” Kenner noted.
The link between metabolic diseases and cancer
This study adds to growing evidence that metabolic pathways may represent an untapped avenue for cancer treatment. Prostate cancer is known to develop from early to late stages, thereby changing the way cells produce energy, thus experiencing significant metabolic metastasis.
Studies have shown that pioglitazone affects several key cellular mechanisms, including reducing the production of mitochondrial ATP (the energy currency of the cell) and affecting MTORs (e.g. MTORs) that regulate cell growth and metabolism.
Looking to the future: The next step in research
Although these results are encouraging, the researchers stress that larger prospective clinical trials are needed before recommending pioglitazone specifically for prostate cancer treatment.
Making this approach particularly attractive is that pioglitazone has established safety data as approved drugs, and if further studies confirm these findings, it may shorten the pathways for clinical use of cancer.
Prostate cancer remains the second largest cancer in men, accounting for about 29% of the cancer incidence in Western countries. New treatments are urgently needed, especially for advanced forms of disease that are resistant to standard treatments.
The study was conducted by an international team, which included scientists from Austria, the Czech Republic, Germany, the United Kingdom and Sweden, and was published in the journal Molecular Cancer.
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