Association of use of sodium-glucose cotransporter 2 inhibitors with outcomes in patients receiving hormone therapy for prostate cancer

While preliminary evidence suggests that sodium-glucose cotransporter 2 (SGLT2) inhibitors for diabetes may have antitumorigenic effects, their potential benefits in prostate cancer remain unexplored. A population-based cohort study with a target trial emulation design in Hong Kong evaluated the association of use of SGLT2 inhibitors with clinical outcomes in prostate cancer patients receiving hormone therapy. The study included 14,223 adult patients starting androgen deprivation therapy (ADT) between January 1, 1993, and April 30, 2025. The median duration of follow-up was 66 months. SGLT2 inhibitor use was associated with reduced risk of ADT failure (HR 0.63; p=0.03) and next-generation hormonal agent failure (HR 0.44; p=0.04). Metformin monotherapy was not associated with disease progression but was associated with improved overall survival (HR 0.59; p=0.002). No statistically significant outcome differences were observed between dapagliflozin and empagliflozin. The authors conclude that these results suggest a potential role of SGLT2 inhibitors as adjuncts to hormonal therapy in the treatment of prostate cancer.