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Nutrition and Exercise Interventions in Reducing Androgen Deprivation Therapy-Induced Obese Frailty in Prostate Cancer Survivors
I. Assess the effect of individualized nutrition and exercise counseling interventions on myokine expression and body composition in prostate cancer (PrCa) patients being treated with androgen deprivation therapy (ADT).
SECONDARY OBJECTIVES:
I. Determine any changes in muscle strength, respiratory muscle strength and functional capacity resulting from the nutrition and exercise counseling interventions.
II. Determine any changes in myokines, circulating inflammatory and frailty-associated cytokines resulting from the nutrition and exercise counseling interventions.
III. Determine the effect of the study interventions on dietary intake, physical activity, fatigue, and quality of life.
EXPLORATORY OBJECTIVES:
I. Correlate changes in secondary objectives with prostate specific antigen (PSA) and testosterone levels.
II. Evaluate adherence to nutrition and exercise advice. III. Evaluate assessment tools and recruiting strategies.
OUTLINE:
Patients receive an individualized diet plan for 6 months. Patients complete an individualized home-based exercise program aerobic and resistance exercise over 10-30 minutes per day, at minimum 3 days per week for 6 months, and a progressive resistance exercise program including an individually tailored prescription targeting the chest, shoulders, arms, and leg musculature for 1-4 sets of 10-15 repetitions, 5 days per week over 6 months. Patients also attend monthly educational meetings for 6 months.
Nutrition and Exercise Interventions to Reduce Androgen Deprivation Therapy-Induced Obese Frailty in Survivors of Advanced Prostate Cancer
- I 72118
- NCI-2019-00341 (Registerkennung) (CTRP (Clinical Trial Reporting Program))
- I 72118 (Andere Kennung) (Roswell Park Cancer Institute)
| Teilnehmergruppe/Studienarm | Intervention/Behandlung |
|---|---|
ExperimentellSupportive care (diet, exercise, education) Patients receive an individualized diet plan for 6 months. Patients complete an individualized home-based exercise program aerobic and resistance exercise over 10-30 minutes per day, at minimum 3 days per week for 6 months, and a progressive resistance exercise program including an individually tailored prescription targeting the chest, shoulders, arms, and leg musculature for 1-4 sets of 10-15 repetitions, 5 days per week over 6 months. Patients also attend monthly educational meetings for 6 months. | Diätetische Intervention Receive diet plan Bildungsintervention Attend educational meeting Bewegungsintervention Complete exercise program Lebensqualitätsbewertung Ancillary studies Umfrageverwaltung Ancillary studies |
| Ergebnismessung | Beschreibung der Messung | Zeitrahmen |
|---|---|---|
Changes in body composition | Will be measured by dual X-ray absorptiometry (DXA) total body and regional lean mass, fat mass and % body fat. | Baseline up to 6 months |
| Ergebnismessung | Beschreibung der Messung | Zeitrahmen |
|---|---|---|
Changes in muscle strength | Will be assessed by chest press, leg press, grip strength,6-minute walk test, timed-up-and-go, agility, Berg balance scale, short physical performance battery (SPPB). | Baseline up to 6 months |
Changes in functional capacity muscle strength | Improvement of muscle strenght | Baseline up to 6 months |
Change in body composition | All subjects will undergo dual-energy X-ray absorptiometry (DEXA) for measurements of body composition | Baseline up to 6 months |
myokines concentration | Will be assessed by serum biomarker levels. | Baseline up to 6 months |
cytokines concentration | Will be assessed by serum biomarker levels. | Baseline up to 6 months |
Health related quality of life Short Form | Will be used to assess quality of life . The SF-36 has eight scaled scores; the scores are weighted sums of the questions in each section. Scores range from 0 - 100, Lower scores = more disability, higher scores = less disability | Up to 6 months |
Changes in dietary intake | Will be assessed by National Cancer Institute Automated Self-Administered 24-hour survey. | Baseline up to 6 months |
Changes in physical activity | Will be assessed by Godin Leisure Time survey and Fitbit activity report. Will be summarized by time point using the observed sample size, mean, and standard deviation. Will be evaluated using a two-sided permutation paired t-test. Additionally, the mean change in each outcome will be estimated using a 95% confidence interval. As exploratory analyses, the association between the change in each outcome and demographic/clinical factors may be evaluated using general linear models. The change in outcome will be modeled as a function of baseline levels and each demographic/clinical factor in a one-at-a-time manner. | Baseline up to 6 months |
Change in fatigue | Will be assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue survey. | Baseline up to 6 months |
Change in Respiratory Muscle Strength | Mouth pressure device | Baseline up to 6 months |
- Biopsy-confirmed prostate adenocarcinoma of any stage/grade
- Prescribed or already receiving continuous ADT for < 5 years
- Hemoglobin > 11 g/dL
- Creatinine < 1.5 x upper limit of normal (ULN), AST or ALT <2 x ULN within 6 months prior to enrollment
- Liver function tests < 2 x ULN
- Able to walk unassisted at least 100 meters (200 steps) or ECOG <= 1
- No contraindications to any aspect of participation, including aerobic exercise
- Participant must be able to read, write, and understand the English language and be able to provide written consent
- Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure
- Known clinically significant severe chronic obstructive pulmonary disease (COPD), ischemic heart disease, congestive heart failure, and/or significant cardiac arrhythmias
- Limiting orthopedic, musculoskeletal or psychological conditions (clinician discretion)
- Overall medical frailty (clinician discretion)
- Any condition contraindicating additional blood collection beyond standard of care
- Unwilling or unable to follow protocol requirements
- Any condition which in the investigator's opinion deems the participant an unsuitable candidate to receive study intervention
New York