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Health Rounds: Older diabetes drugs appear to slow prostate cancer in small study
By Nancy Lapid - 5/21/2025
(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays.)
By Nancy Lapid
(Reuters) - A class of older drugs used to treat type 2 diabetes may also help slow the progression of prostate cancer, a small study suggests.
Prostate cancer patients with diabetes who were receiving a class of medications called thiazolidinediones, or TZDs, that target the protein PPAR-gamma, “remained relapse-free during the period we followed them," study leader Dr. Lukas Kenner of Umea University in Sweden said in a statement. "This is a significant discovery.”
By targeting PPAR-gamma, the drugs help the body use insulin more effectively, reducing blood sugar levels. It has also been reported that PPAR-gamma can contribute to tumor growth and worse outcomes in some types of cancer.
Tracking 69 patients who underwent surgery for localized prostate cancer, including 49 with diabetes, the researchers found that 10 years later, the only ones remaining free of biochemical recurrence – that is, a rise in PSA levels without any other signs or symptoms - were the three with diabetes who had been taking PPAR-gamma-targeting TZDs.
In test tube experiments, researchers saw that the drug pioglitazone, sold as Actos by Takeda Pharmaceuticals, not only inhibited prostate cancer cell division and growth but also drove a metabolic reprogramming of the cancer cells, weakening their ability to survive and spread.
“Our findings position pioglitazone and similar metabolic inhibitors at the forefront of emerging therapeutic strategies for prostate cancer,” the researchers concluded in a report published in Molecular Cancer.
However, they noted that larger, long-term studies are needed to fully determine the impact of TZDs "on the development and progression of prostate cancer and patient survival.”
WOMEN OF AFRICAN AND SOUTH ASIAN ANCESTRY NEED TAILORED CANCER SCREENING
A new study of women with breast cancer found that patients of African or South Asian ancestry have important genetic differences that are not seen in those of European descent, which should be taken into consideration when diagnosing and treating their disease.
People of European ancestry have accounted for nearly 80% of participants in genetic association studies, despite representing only 16% of the global population, which means most of what is known about risk, prevention, and treatment is based predominantly on European populations, the researchers said.
“Precision medicine has the power to revolutionize cancer care, but only if it works for everyone,” study leader Dr. Claude Chelala of Queen Mary’s Barts Cancer Institute in the UK said in a statement.
As reported on Tuesday in Nature Communications, researchers analyzed genetic data and medical records from over 7,000 U.S. and UK women with breast cancer of African, South Asian and European ancestry.
They found that patients of African or South Asian ancestry tend to develop breast cancer and die at a younger age than women of European ancestry, suggesting that screening should start at earlier ages in these women. Women of South Asian backgrounds died 13 years younger and those of African ancestry 9 years younger, researchers found.
Their study also identified differences in mutation rates in genes linked to breast cancer susceptibility, which are used in genetic testing and influence treatment decisions.
Some women had genetic mutations that could have made their cancer resistant to certain treatments that they received, but this was not factored into their clinical management.
“If we fail to address blind spots in research, we risk widening health inequalities rather than reducing them,” Chelala said.
DELIRIUM GOES UNDETECTED IN U.S. PATIENTS WHO SPEAK SPANISH
Standard tools for diagnosing delirium in the intensive care unit are inaccurate in Spanish-speaking patients, researchers reported at the American Thoracic Society 2025 International Conference in San Francisco.
Dr. Ana Lucia Fuentes Baldarrago of the University of California, San Diego undertook the study when she found Spanish-speaking ICU patients who were classified as not delirious showed clear signs of delirium when engaged in Spanish.
She had also encountered patients labeled as delirious who were simply unable to communicate effectively because they did not speak English.
In 63 ICU patients – 29 Spanish-speakers and 34 English-speakers – her team compared three delirium assessment tools.
Two are administered by providers: the English-language Confusion Assessment Method (CAM) for the ICU, and a Spanish-language version of the same tool.
The third tool was a new version of the Spanish-language tool designed by the researchers for family caregivers to complete. While the Spanish CAM is the gold-standard assessment for Spanish-speaking patients when administered by a Spanish-speaking provider, there are not enough bilingual providers available to administer it in the United States.
Traditional screening methods were not accurate in Spanish-speaking ICU patients when the patient and provider did not speak the same language, the researchers found.
Their new Spanish assessment for families to complete was comparable to gold-standard assessments and outperformed usual screening practices in detecting delirium.
“These findings underscore the urgent need to evaluate commonly used clinical tools in diverse populations, particularly among non-English-speaking patients who are frequently excluded from clinical trials,” Fuentes Baldarrago said
Spanish-speaking patients also had significantly higher odds of being subjected to physical restraints and deep sedation, and lower odds of receiving evidence-based, delirium-prevention interventions such as physical and occupational therapy, Fuentes Baldarrago said.
Her team hopes to conduct larger studies of their tool for families to evaluate whether its use can reduce misclassification and improve clinical outcomes.
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(Reporting by Nancy Lapid; editing by Bill Berkrot)