Considering its satisfactory tolerance in humans, metformin has recently been repurposed as a new adjuvant therapy in PCa management.6–8 Metformin can directly inhibit complex I in the electron transport chain to induce the phosphorylation of Adenosine Monophosphate-Activated Protein Kinase (AMPK), which consequently inhibits the PI3K/AKT/mTOR pathway, gluconeogenesis, and OXPHOS.6–8 In addition, metformin was found to not only interfere with androgen signaling, but also reduce the side effects of ADT.40 However, the clinical effect of metformin on PCa therapy appears to be uncertain. This evidence concerns the gene MTOR and posterior cortical atrophy.