MedPath

To examine the clinical effectiveness of aspirin and/or Vitamin D3 to prevent disease progression in men on active surveillance for prostate cancer

Not Applicable
Completed
Conditions
Prostate cancer
Cancer
Registration Number
ISRCTN91422391
Lead Sponsor
Queen Mary University of London (UK)
Brief Summary

2022 Results article in https://doi.org/10.1002/bco2.169 (added 08/07/2022)

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
Male
Target Recruitment
130
Inclusion Criteria

Current inclusion criteria as of 10/12/2018:
1. Male subjects aged 16 years or over with an estimated life expectancy of more than three years
2. Willing and able to provide written informed consent
3. Corrected serum calcium <2.65 mmol/l
4. No previous treatment for prostate cancer (including surgery, hormone therapy, radiotherapy, cryotherapy)
5. All subjects must have had Magnetic Resonance Imaging (MRI) of the prostate with targeted biopsy of any lesions identified
6. Histologically confirmed prostate cancer* following prostate biopsy (including at least 10 cores of prostate tissue) in men opting for Active Surveillance as their primary cancer therapy

*PROVENT Prostate Cancer Criteria for Inclusion:
1. Gleason score 6 or 7 (Gleason 3+3 or 3+4)
2. Clinical and radiological stage 3. Serum PSA of 15.0 ng/ml or below
Less than 10 mm of cancer in a single core

7. Patients must have undergone a multi-parametric MRI deemed assessable by the local radiologist, and any lesions seen must have undergone targeted biopsy (transrectal or transperineal) within 12 months of study enrolment.

Previous inclusion criteria:
1. Male subjects aged 16 years or over with an estimated life expectancy of more than three years
2. Willing and able to provide written informed consent
3. Corrected serum calcium <2.65mmol/l
4. No previous treatment for prostate cancer (including surgery, hormone therapy, radiotherapy, cryotherapy)
5. All subjects must have had Magnetic Resonance Imaging (MRI) of the prostate with targeted biopsy of any lesions identified
6. Histologically confirmed prostate cancer* following prostate biopsy (including at least 10 cores of prostate tissue) in men opting for Active Surveillance as their primary cancer therapy

*PROVENT Prostate Cancer Criteria for Inclusion:
1. Gleason score 6 or 7
2. Clinical and radiological stage 3. Serum PSA of 15.0 ng/ml or below
Less than 10mm of cancer in a single core

7. Patients must have undergone a multi-parametric MRI deemed assessable by the local radiologist, and any lesions seen must have undergone targeted biopsy (transrectal or transperineal) within 12 months of study enrolment.

Exclusion Criteria

Current exclusion criteria as of 10/12/2018:
1. Previously treated prostate cancer (including radiotherapy, hormone therapy, brachytherapy or surgery)
2. Current enrolment in an investigational drug, device or other clinical research study or participation in such a study within 30 days of randomisation
3. Current daily use of aspirin or NSAIDs; or daily dietary supplements/medication containing more than 400 IU (10 micrograms per day)Vitamin D; or chronic use (defined as > 6 months continuous daily use) of either aspirin or Vitamin D within two years of study enrolment
4. Current or previous use of 5-alpha-reductase inhibitors such as finasteride or dutasteride
5. Not willing to comply with the procedural requirements of this protocol including repeat prostate biopsies
6. Known allergy/sensitivity to or intolerance of aspirin, other salicylates or NSAIDs e.g. ibuprofen/ naproxen
7. Prior history of gastro-intestinal bleeding or ulceration, severe dyspepsia or inflammatory bowel disease
8. Haemophilia or other bleeding diatheses
9. Prior history of renal stone disease
10. Chronic renal disease (= stage 4)
11. Known hypercalcaemia (corrected serum calcium >2.65 mmol/l) or untreated hyperparathyroidism
12. Any bowel condition that would make repeat transrectal biopsy hazardous or difficult to perform e.g. recto-urethral fistula, or prior bowel surgery such as abdomino-perineal resection.
13. Any malignancy (other than non-melanoma skin cancer) that has not been in complete remission for five years
14. Any serious co-existent medical condition that would make repeat prostate biopsy hazardous e.g. anti-coagulation requiring continuous administration
15. Severe Asthma
16. G6PD deficiency
17. Pre-existing macular degeneration
18. All contraindications to aspirin and Vitamin D (e.g. Sarcoidosis), including concomitant therapy with any medication that may interact with aspirin or Vitamin D
19. Tuberculosis
20. Regular consumption of alcohol units greater than the recommended daily limit of 3-4 units per day (men)

Previous exclusion criteria:
1. Previously treated prostate cancer (including radiotherapy, hormone therapy, brachytherapy or surgery)
2. Current enrolment in an investigational drug, device or other clinical research study or participation in such a study within 30 days of randomisation
3. Current daily use of aspirin or NSAIDs; or daily dietary supplements/medication containing more than 400 IU (10 micrograms per day)Vitamin D; or chronic use (defined as > 6 months continuous daily use) of either aspirin or Vitamin D within two years of study enrolment
4. Current or previous use of 5-alpha-reductase inhibitors such as finasteride or dutasteride
5. Not willing to comply with the procedural requirements of this protocol including repeat prostate biopsies
6. Known allergy/sensitivity to or intolerance of aspirin, other salicylates or NSAIDs e.g. ibuprofen/ naproxen
7. Prior history of gastro-intestinal bleeding or ulceration, severe dyspepsia or inflammatory bowel disease

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Rate of patient recruitment to a randomised chemoprevention study in men enrolled on an Active Surveillance programme for prostate cancer. This will be determined by screening logs and screening/randomisation case report forms.
Secondary Outcome Measures
NameTimeMethod
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