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Lifestyle Intervention in Patients With Metastatic Prostate Cancer

Not Applicable
Recruiting
Conditions
Prostate Cancer
Interventions
Behavioral: Lifestyle intervention
Registration Number
NCT05850182
Lead Sponsor
Oncology Institute of Southern Switzerland
Brief Summary

The proposed pilot study aims at determining the feasibility of a lifestyle intervention including adherence to a personalised dietary regimen combined with regular physical activity in patients newly diagnosed with prostate cancer under androgen deprivation therapy.

Detailed Description

Prostate cancer (PCa) is among the most frequent tumor types and is the second deadliest type of cancer in men.

PCa has a multifactorial aetiology; modifiable environmental factors, including diet and obesity, have been associated with prostate carcinogenesis. Furthermore, patients with PCa are treated with androgen deprivation therapy (ADT), which has negative effects on the cardiovascular system and body composition, particularly on the fat and muscle mass, bone health and psychological wellbeing.

Data in the current literature suggests that a lifestyle intervention e.g. with targeted and supervised exercise therapy or a dietary intervention with a prudent dietary patternmay positively influence the quality of life and the course of the disease of patients under ADT. However, conclusive data is missing.

The proposed pilot study aims at determining the feasibility and the effect of a lifestyle intervention including adherence to a personalised dietary regimen combined with regular physical activity in patients newly diagnosed with PCa under ADT.

Recruitment & Eligibility

Status
RECRUITING
Sex
Male
Target Recruitment
30
Inclusion Criteria
  • Written informed consent according to ICH/GCP regulations before registration.
  • Age ≥ 18 years
  • Histology of adenocarcinoma of the prostate
  • Patients with PCa receiving ADT alone or ADT+NHT (abiraterone, enzalutamide, apalutamide or darolutamide)
  • Rising PSA (two consecutively rising PSA levels > 25% above nadir at least three weeks apart), with no evidence of clinical or radiographic progression on instrumental evaluation
  • PSA doubling time > 8 weeks
  • Continuation of ongoing systemic treatment is deemed feasible by treating physician
Exclusion Criteria
  • Ongoing treatment with docetaxel, cabazitaxel, radionuclides or investigational treatments
  • Evidence of clinical progression or progression of disease on imaging
  • Bone metastases excluding the safety of physical exercise
  • Prior confirmed severe osteoporosis or other diseases affecting the bone with history of fractures
  • Clinically significant cardiovascular disease (i.e. myocardial infarction within 6 months before screening; uncontrolled angina within 3 months before screening; congestive heart failure New York Heart Association class 3 or 4; history of clinically significant arrhythmias; uncontrolled hypertension indicated by systolic blood pressure > 170 mm Hg or diastolic blood pressure > 105 mm Hg at screening)
  • Clinically significant chronic obstructive pulmonary disease
  • Any concurrent disease or comorbid condition that interferes with the ability of the patient to participate in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Arm treated with lifestyle interventionLifestyle interventionPatients with prostate cancer will receive a lifestyle intervention on diet and physical activity.
Primary Outcome Measures
NameTimeMethod
Patient initiation rate12 weeks

Study initiation rate (total number of patients enrolled divided by the number of patients screened for the study)

Adherence to prescribed training program12 weeks

Adherence rate (fraction of scheduled physical activity appointments/selftrainings attended/carried out by the patients)

Patient retention rate12 weeks

Retention rate (number of patients completing the study divided by total number of patients enrolled at baseline)

Adherence to prescribed dietary regimen12 weeks

Adherence rate (fraction of days of adherence to the prescribed dietary regimen)

Secondary Outcome Measures
NameTimeMethod
Effect of lifestyle intervention on PSA progression24 weeks

Percentage of PSA non-progressors (patients with \<25% PSA rise compared to baseline) at weeks 8, 12 and 24

Effect of lifestyle intervention on PSA levels24 weeks

PSA doubling time calculated with the formula PSA doubling time = ln (2) / PSA Slope \[PSA Slope = (ln (PSA level 2) - ln (PSA level 1)) / Time (no. of months)\]

Effect of lifestyle intervention on time to subsequent treatment24 months

Time to a subsequent line of treatment (in weeks)

Effect of lifestyle intervention on plasma immune signature8 weeks

Concentration of inflammatory cytokines in the plasma of participating patients, change compared to baseline

Effect of lifestyle intervention on radiographic progression24 weeks

Percentage of patients being free of radiographic progression according to PCWG3 at weeks 12 and 24

Effect of lifestyle intervention on patient-reported quality of life24 weeks

Change in patient-reported quality of life from baseline using Functional Assessment of Cancer Therapy - Prostate (FACT-P) scoring from baseline to weeks 8, 12 and 24

Effect of lifestyle intervention on patient-reported fatigue24 weeks

Change in patient-reported fatigue from baseline using FACIT Fatigue scoring from baseline to weeks 8, 12 and 24

Effect of lifestyle intervention on plasma lipid signature8 weeks

Concentration of individual lipid types in the plasma of participating patients, change compared to baseline

Effect of lifestyle intervention on microbiome composition8 weeks

Differences in community diversity and/or abundance of specific bacterial taxa within the intestinal microbiome prior to or during the lifestyle intervention.

Effect of lifestyle intervention on anthropometric variables24 weeks

Measurement of patient height and body weight and calculation of body-mass index (BMI) at baseline, during and after the lifesyle intervention.

Effect of lifestyle intervention on lean body mass12 weeks

Measurement of the percentage of lean body mass by bioelectrical impedance vector analysis and by magnetic resonance imaging.

Effect of lifestyle intervention on fat body mass12 weeks

Measurement of the percentage of fat body mass by bioelectrical impedance vector analysis and by magnetic resonance imaging.

Trial Locations

Locations (1)

Oncology Institute of Southern Switzerland (IOSI)

🇨🇭

Bellinzona, Switzerland

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