Prostatic Neoplasms
Conditions
Keywords
prostatic neoplasms, bicalutamide, quality of life, osteoporosis
Brief summary
The aim of this study is to comprehensively monitor the effects of a nonsteroidal antiandrogen in patients requiring hormone manipulation for prostate cancer
Detailed description
Androgen deprivation therapy is the mainstay of treatment for advanced prostate cancer. There is an increasing tendency towards earlier treatment with hormone manipulation. However, luteinizing hormone-releasing agonists decrease serum testosterone to castrate levels within two weeks of commencement.They are associated with loss of libido, loss of muscle bulk and accelerated bone loss. Osteoporotic patients are at high risk of fragility fractures. An alternative is the nonsteroidal antiandrogen bicalutamide which blocks testosterone at the receptor level, allowing androgen deprivation in the prostate without reducing circulating levels of testosterone. This should preserve the desired effects on other androgen-sensitive tissue, resulting in an advantageous side effect profile. The aim of our study is to closely monitor osteoporotic patients commencing bicalutamide for a period of 12 months. Patients will be reviewed in a dedicated prostate cancer clinic every 3 months. Patients will be questioned regarding adverse events. Renal and liver function tests, prostate specific antigen, testosterone, estradiol and bone turnover markers will be measured 3 monthly. Measurement of height , weight, body mass index, quadriceps strength using dynamometry, and skeletal mass using arm anthropometry (mid-arm circumference and triceps skinfold thickness), will be carried out 3 monthly. Quality of life issues will be assessed 3 monthly using the Rand 36-Item Health Survey (SF36) and University of California-Los Angeles Prostate Cancer Index (UCLAPCI). Patients will undergo bone densitometry of the forearm at baseline and 12 months.
Interventions
DRUGBicalutamide
Bicalutamide 150mg once daily, oral administration, for 12 months
Sponsors
AstraZeneca
Wirral University Teaching Hospital NHS Trust
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Healthy volunteers
No
Inclusion criteria
* Osteoporotic patients (T score ≤ -2.5) with advanced prostate cancer requiring hormone manipulation, due to biochemical relapse following either radical prostatectomy, radiotherapy, brachytherapy, or biochemical progression after initially being observed with prostate cancer.
Exclusion criteria
* Severe hepatic insufficiency, with bilirubin above reference range * Previous systemic therapy for prostate cancer * Radiotherapy within 6 months * Previous other invasive malignancies * Any severe concomitant disease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Quality of life (using Rand 36-Item Health Survey SF-36) | 3 monthly for 1 year |
Secondary
| Measure | Time frame |
|---|---|
| Renal & liver function tests, PSA, testosterone, estradiol | 3 monthly for 1 year |
| Body Mass Index, arm anthropometry (mid-upper arm circumference and triceps skin fold thickness), dynamometry (quadriceps muscle strength) | 3 monthly for 1 year |
| Bone turnover markers (bone-specific alkaline phosphatase, N-terminal propeptide of type I collagen, C-telopeptide crosslinks of type I collagen, urine N-telopeptide of tyoe I collagen corrected for creatinine | 3 monthly for 12 months |
| Peripheral bone densitometry of non-dominant forearm | At baseline and 12 months |
Countries
United Kingdom
Outcome results
None listed