Modifying Metabolic Syndrome and Cardiovascular Risk for Prostate Cancer Patients on ADT Using a Risk Factor Modification Program and Continuous Fitbit Monitoring

NCT ID: NCT05054296

Last Updated: 2023-03-29

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE2
• Total Enrollment: 200 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-03-23
• Study Completion Date: 2027-02-02

Brief Summary

This phase II trial studies how well an exercise program and continuous Fitbit monitoring work for managing metabolic syndrome and cardiovascular disease risk in patients with prostate cancer that has spread to other places in the body (metastatic) or has come back (recurrent) and does not response to treatment (refractory) and are receiving androgen deprivation therapy. Balancing treatment efficacy, drug side effects, and competing comorbidities with prostate cancer is essential. This trial is being done to learn if an exercise program can help to improve metabolic syndrome and cardiovascular (heart) fitness in prostate cancer patients who are receiving androgen deprivation therapy.

Detailed Description

PRIMARY OBJECTIVE:

I. Determine the relationship between a 16-week exercise program with continuous Fitbit monitoring and cardiovascular fitness (defined by change in 10-year atherosclerotic cardiovascular disease [ASCVD] risk score), as compared to Fitbit monitoring alone, in prostate cancer patients on androgen deprivation therapy (ADT).

SECONDARY OBJECTIVES:

I. Determine the length of cardiovascular fitness effect (measured using 10-year ASCVD risk 12 weeks post intervention) for a 16-week exercise program with continuous Fitbit monitoring in prostate cancer patients on ADT.

II. Screen for a relationship between a 16-week exercise program with continuous Fitbit monitoring and metabolic syndrome severity (defined by change in metabolic severity index z-score), as compared to Fitbit monitoring alone, in prostate cancer patients on ADT.

III. Measure the relationship between the exercise intervention and prostate-specific antigen (PSA) velocity, compared to Fitbit monitoring alone.

IV. Measure the relationship between the exercise intervention and physical fitness (using V02 and body composition), compared to Fitbit monitoring alone.

V. Measure the relationship between the exercise intervention and physical activity (step count)/heart rate, compared to Fitbit monitoring alone.

VI. Measure the relationship between the exercise intervention and physical activity (as measured by the Godin Leisure Time Physical Activity Questionnaire) compared to Fitbit monitoring alone.

VII. Measure the relationship between the exercise intervention and, quality of life/symptom burden, compared to Fitbit monitoring alone (measured by the following patient reported surveys: National Cancer Institute-patient reported outcomes-Common Terminology Criteria for Adverse Events [NCI-PRO-CTCAE], Patient Reported Outcomes Measurement Information System [PROMIS] Fatigue and Physical Function, Self Efficacy, European Organization for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire Core30 [QLQ-C30] and Prostate Cancer 25 [PR25]).

EXPLORATORY OBJECTIVE:

I. Explore the relationship between the exercise intervention and markers of insulin resistance, inflammation/immune function and metabolism utilizing pre- and post-intervention peripheral blood analysis.

OUTLINE: Patients are randomized to 1 of 2 groups.

GROUP I: Patients receive general education exercise packet with instruction to exercise regularly for up to 150 minutes weekly. Patients also wear a FitBit daily over 16 weeks.

GROUP II: Patients participate in supervised and self-directed exercise sessions over 60 minutes twice a week (BIW) for up to 16 weeks. Patients also wear a FitBit daily over 16 weeks.

Conditions

Biochemically Recurrent Prostate Carcinoma; Metastatic Prostate Adenocarcinoma; Stage IV Prostate Cancer AJCC v8; Stage IVA Prostate Cancer AJCC v8; Stage IVB Prostate Cancer AJCC v8

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Group I (education exercise packet, FitBit)

Patients receive general education exercise packet with instruction to exercise regularly for up to 150 minutes weekly. Patients also wear a FitBit daily over 16 weeks.

Group Type: ACTIVE_COMPARATOR

Educational Intervention

Intervention Type: BEHAVIORAL

Receive general education exercise packet

FitBit

Intervention Type: DEVICE

Wear FitBit for activity tracking

Quality-of-Life Assessment

Intervention Type: OTHER

Ancillary studies

Questionnaire Administration

Intervention Type: OTHER

Ancillary studies

Group II (exercise program FitBit)

Patients participate in supervised and self-directed exercise sessions over 60 minutes BIW for up to 16 weeks. Patients also wear a FitBit daily over 16 weeks.

Group Type: EXPERIMENTAL

Exercise Intervention

Intervention Type: BEHAVIORAL

Participate in supervised and self-directed exercise sessions

FitBit

Intervention Type: DEVICE

Wear FitBit for activity tracking

Quality-of-Life Assessment

Intervention Type: OTHER

Ancillary studies

Questionnaire Administration

Intervention Type: OTHER

Ancillary studies

Interventions

Educational Intervention

Receive general education exercise packet

Intervention Type: BEHAVIORAL

Exercise Intervention

Participate in supervised and self-directed exercise sessions

Intervention Type: BEHAVIORAL

FitBit

Wear FitBit for activity tracking

Intervention Type: DEVICE

Quality-of-Life Assessment

Ancillary studies

Intervention Type: OTHER

Questionnaire Administration

Ancillary studies

Intervention Type: OTHER

Other Intervention Names

Education for Intervention; Intervention by Education; Intervention through Education; Intervention, Educational; Quality of Life Assessment

Eligibility Criteria

Inclusion Criteria

• Willing and able to provide written informed consent
• Histologically or cytologically confirmed adenocarcinoma of the prostate
• Presence of metastatic disease documented on imaging studies (bone scan, computed tomography [CT] and/or magnetic resonance imaging [MRI]) or biochemical recurrence/refractoriness following local therapy (prostatectomy or radiation)
• Stable or improving disease activity as demonstrated by stable or improving PSA over at least 2 months
• On gonadotropin-releasing hormone (GnRH) agonist or GnRH antagonist or status post-surgical castration for at least 3 months
• Combination ADT with abiraterone or enzalutamide is permitted
• Anticipation to remain hypogonadal for at least 6 months subsequently
• Asymptomatic bone metastasis is permissible (exercise will be modified and patients monitored)
• Eastern Cooperative Oncology Group (ECOG) performance status of =< 2
• Patients must be able to finish a maximal exercise stress test which will be assessed by cardiopulmonary exercise testing using a standardized protocol ^70 supervised by a cardiologist
• Hemoglobin >= 9.0 g/dL independent of transfusion and/or growth factors within 3 months prior to enrollment
• Platelet count >=75,000/uL independent of transfusion and/or growth factors within 3 months prior to enrollment
• Access to a smart phone with android or iPhone OS (iOS) operating systems
• Able to speak and comprehend English

Exclusion Criteria

• Current use of any other systemic therapy for prostate cancer with the exception of gonadotrophin releasing hormone (GnRH) agonists/antagonists, abiraterone, enzalutamide, bisphosphonates or RANK-ligand inhibitors (for bone metastases) which are allowed
• Any underlying comorbid medical or psychiatric condition, which in the opinion of the Investigator, will make participation in our exercise intervention hazardous or obscure the interpretation of adverse events
• Inability to walk 400 meters or undertake upper and lower limb exercise, and resistance training in the previous 3 months
• Chemotherapy treatment within 28 days of study enrollment
• Symptomatic bone metastasis
• Any investigational pharmaceutical products
• Radiation therapy or surgical intervention for prior bone metastasis
• Clinically significant active malignancy other than prostate cancer
• Prolonged corrected QT (QTc) interval on pre-entry electrocardiogram (>= 450 m/sec)
• Clinically significant heart disease that may impact safety of independent or supervised exercise including preexisting coronary artery disease, myocardial infarction or arterial thrombotic events in the past 6 months, severe or unstable angina, history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsade de pointes), New York Heart Association Class III-IV heart disease or cardiac ejection fraction measurement of < 40% at baseline
• Untreated symptomatic spinal cord compressions
• Prisoners or subjects who are involuntarily incarcerated
• Subjects who are compulsorily detained for treatment of either a psychiatric or physical (e.g. infectious disease) illness

• Minimum Eligible Age: 18 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Christopher J Logothetis

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

M D Anderson Cancer Center

Houston, Texas, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Christopher J Logothetis

Role: CONTACT

clogothe@mdanderson.org

7135637210

Facility Contacts

Christopher J. Logothetis

Role: primary

713-792-2830

Related Links

http://www.mdanderson.org

MD Anderson Cancer Center

Other Identifiers

NCI-2019-08624

Identifier Type: REGISTRY

Identifier Source: secondary_id

2018-0938

Identifier Type: OTHER

Identifier Source: secondary_id

2018-0938

Identifier Type: -

Identifier Source: org_study_id