Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case Report
ABSTRACT Introduction Docetaxel is a key treatment for castration‐resistant prostate cancer and is administered with prednisolone, which increases the risk of steroid‐induced diabetes. Its myelosuppressive effect also increases vulnerability to febrile neutropenia. Metformin is widely used for glyce...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
|
| Series: | IJU Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/iju5.70055 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850109245735829504 |
|---|---|
| author | Y. Inoue A. Niimi T. Kudo U. Yoshizaki Y. Sato H. Kume |
| author_facet | Y. Inoue A. Niimi T. Kudo U. Yoshizaki Y. Sato H. Kume |
| author_sort | Y. Inoue |
| collection | DOAJ |
| description | ABSTRACT Introduction Docetaxel is a key treatment for castration‐resistant prostate cancer and is administered with prednisolone, which increases the risk of steroid‐induced diabetes. Its myelosuppressive effect also increases vulnerability to febrile neutropenia. Metformin is widely used for glycemic control; however, elderly cancer patients are particularly susceptible to metformin‐associated lactic acidosis, necessitating careful management of sick‐day and febrile neutropenia during chemotherapy. Case Presentation We report a 70‐year‐old male with castration‐resistant prostate cancer and diabetes mellitus who developed febrile neutropenia on Day 5 following docetaxel initiation. He progressed to shock with severe metabolic acidosis on Day 7 and died despite intensive care, including continuous renal replacement therapy. A retrospective review revealed continued metformin use despite prodromal fatigue and loss of appetite, likely due to impaired judgment. Conclusion This case may have involved septic shock, but metformin likely worsened the lactic acidosis. It highlights the need for sick‐day education and monitoring in elderly cancer patients. |
| format | Article |
| id | doaj-art-9164818e64624b248bd56ecdd652cd39 |
| institution | OA Journals |
| issn | 2577-171X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | IJU Case Reports |
| spelling | doaj-art-9164818e64624b248bd56ecdd652cd392025-08-20T02:38:09ZengWileyIJU Case Reports2577-171X2025-07-018441141410.1002/iju5.70055Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case ReportY. Inoue0A. Niimi1T. Kudo2U. Yoshizaki3Y. Sato4H. Kume5Department of Urology The New Tokyo Hospital Chiba JapanDepartment of Urology The New Tokyo Hospital Chiba JapanDepartment of Urology National Center for Global Health and Medicine Tokyo JapanDepartment of Urology The New Tokyo Hospital Chiba JapanDepartment of Urology The New Tokyo Hospital Chiba JapanDepartment of Urology, Graduate School of Medicine The University of Tokyo Tokyo JapanABSTRACT Introduction Docetaxel is a key treatment for castration‐resistant prostate cancer and is administered with prednisolone, which increases the risk of steroid‐induced diabetes. Its myelosuppressive effect also increases vulnerability to febrile neutropenia. Metformin is widely used for glycemic control; however, elderly cancer patients are particularly susceptible to metformin‐associated lactic acidosis, necessitating careful management of sick‐day and febrile neutropenia during chemotherapy. Case Presentation We report a 70‐year‐old male with castration‐resistant prostate cancer and diabetes mellitus who developed febrile neutropenia on Day 5 following docetaxel initiation. He progressed to shock with severe metabolic acidosis on Day 7 and died despite intensive care, including continuous renal replacement therapy. A retrospective review revealed continued metformin use despite prodromal fatigue and loss of appetite, likely due to impaired judgment. Conclusion This case may have involved septic shock, but metformin likely worsened the lactic acidosis. It highlights the need for sick‐day education and monitoring in elderly cancer patients.https://doi.org/10.1002/iju5.70055castration‐resistant prostate cancerchemotherapymetformin‐associated lactic acidosispatient educationsick‐day management |
| spellingShingle | Y. Inoue A. Niimi T. Kudo U. Yoshizaki Y. Sato H. Kume Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case Report IJU Case Reports castration‐resistant prostate cancer chemotherapy metformin‐associated lactic acidosis patient education sick‐day management |
| title | Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case Report |
| title_full | Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case Report |
| title_fullStr | Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case Report |
| title_full_unstemmed | Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case Report |
| title_short | Metformin‐Associated Lactic Acidosis During Docetaxel Therapy for Castration‐Resistant Prostate Cancer: A Case Report |
| title_sort | metformin associated lactic acidosis during docetaxel therapy for castration resistant prostate cancer a case report |
| topic | castration‐resistant prostate cancer chemotherapy metformin‐associated lactic acidosis patient education sick‐day management |
| url | https://doi.org/10.1002/iju5.70055 |
| work_keys_str_mv | AT yinoue metforminassociatedlacticacidosisduringdocetaxeltherapyforcastrationresistantprostatecanceracasereport AT aniimi metforminassociatedlacticacidosisduringdocetaxeltherapyforcastrationresistantprostatecanceracasereport AT tkudo metforminassociatedlacticacidosisduringdocetaxeltherapyforcastrationresistantprostatecanceracasereport AT uyoshizaki metforminassociatedlacticacidosisduringdocetaxeltherapyforcastrationresistantprostatecanceracasereport AT ysato metforminassociatedlacticacidosisduringdocetaxeltherapyforcastrationresistantprostatecanceracasereport AT hkume metforminassociatedlacticacidosisduringdocetaxeltherapyforcastrationresistantprostatecanceracasereport |