Prostate Cancer
Conditions
Keywords
stage I prostate cancer, stage II prostate cancer, adenocarcinoma of the prostate
Brief summary
RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent or delay the development of early cancer. Soy isoflavones may be effective in delaying the development of early prostate cancer. PURPOSE: This randomized phase II trial is studying different regimens of soy isoflavones to compare how well they work in treating patients who are undergoing radical prostatectomy for stage I or stage II prostate cancer (adenocarcinoma).
Detailed description
OBJECTIVES: * Compare blood/prostate biomarkers of oxidative stress and prostate cancer risk in patients with stage I or II adenocarcinoma of the prostate treated with 3 different dose levels of soy isoflavones before radical prostatectomy. * Compare prostatic tissue biomarkers of proliferation and apoptosis in patients treated with these regimens. * Determine the potential response, in terms of tumor and prostatic intraepithelial neoplasia grade and volume, extraprostatic extension, and serum prostate-specific antigen level, in patients treated with soy isoflavones and in those treated with placebo. * Determine the safety of soy isoflavone supplementation in these patients. OUTLINE: This is a randomized, double-blind, placebo-controlled, parallel-group study. Patients are stratified according to tumor stage (T1c vs T2). Patients are randomized to 1 of 4 treatment arms. * Arm I (control group): Patients receive oral placebo once daily. * Arm II: Patients receive oral soy isoflavones and oral placebo once daily. * Arm III: Patients receive a higher dose of oral soy isoflavones and oral placebo once daily. * Arm IV: Patients receive a higher dose (higher than arm III) of oral soy isoflavones once daily. In all arms, treatment continues for 2-6 weeks (depending on the time from study entry to planned surgery) in the absence of unacceptable toxicity. All patients then undergo radical prostatectomy. Patients are followed at 1 week. PROJECTED ACCRUAL: A total of 100 patients (25 per treatment arm) will be accrued for this study within 12.5 months.
Interventions
DIETARY_SUPPLEMENTsoy isoflavones
PROCEDUREneoadjuvant therapy
Prostatectomy or Brachytherapy
OTHERPlacebo
Arm I: 4 placebo capsules Arm II: 3 placebo capsules Arm III: 2 placebo capsules
Sponsors
National Cancer Institute (NCI)
Barbara Ann Karmanos Cancer Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically confirmed adenocarcinoma of the prostate * Stage T1c or T2 * Disease confined to the prostate gland * Planning to undergo radical prostatectomy within the next 3-4 weeks PATIENT CHARACTERISTICS: Age * 18 and over Performance status * Not specified Life expectancy * Not specified Hematopoietic * Not specified Hepatic * ALT and AST less than 2 times upper limit of normal (ULN) * Alkaline phosphatase less than 2 times ULN Renal * Not specified Other * Fertile patients must use effective barrier contraception * Medically cleared for surgery * No concurrent thyroid disease PRIOR CONCURRENT THERAPY: Biologic therapy * No prior biological therapy for prostate cancer * No concurrent biological agents Chemotherapy * No prior chemotherapy for prostate cancer * No concurrent chemotherapy Endocrine therapy * No prior hormonal therapy for prostate cancer * No concurrent thyroid hormone replacement medication * No concurrent hormonal therapy Radiotherapy * Not specified Surgery * See Disease Characteristics Other * At least 3 months since prior high-dose nutritional supplements * No concurrent regular use (more than once weekly) of soy products greater than 50 g of soy protein or 50 mg of soy isoflavone * No concurrent high-dose nutritional supplements * Standard-dose single multivitamin tablet (e.g., Centrum™) allowed * No concurrent herbs * No concurrent soy foods * No other concurrent isoflavone supplements * No other concurrent antineoplastic agents
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Oxidative DNA damage as measured by 5-hydroxymethyluridine level | at 3 weeks |
| Lipid oxidation as measured by 8-isoprostane level | at 3 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Tumor size, grade, and extension | at 3 weeks |
| Prostate-specific antigen and prostatic intraepithelial neoplasia grade | at 3 weeks |
| Biomarkers of cell growth, differentiation, and apoptosis | at 3 weeks |
| Toxicity as measured by number and grade of adverse events | at 3 weeks |
Countries
United States
Outcome results
None listed