Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA.
The University of Arizona Cancer Center, Tucson, AZ, USA.
Prostate Cancer Prostatic Dis. 2021 Sep;24(3):903-909. doi: 10.1038/s41391-021-00346-z. Epub 2021 Mar 25.
Androgen deprivation therapy (ADT) for prostate cancer is associated with adverse effects, such as obesity and metabolic syndrome, which increase cardiovascular risk, the most common cause of non-cancer mortality in men diagnosed with prostate cancer. The Comprehensive Lifestyle Improvement Program for Prostate Cancer (CLIPP) was created to determine the feasibility of conducing a comprehensive lifestyle modification intervention in men on ADT for prostate cancer and determine its early efficacy in reducing obesity and metabolic syndrome.
A single-arm, open-label clinical trial was conducted by recruiting 31 men diagnosed with prostate cancer and exposed to ADT within the last 5 years. A multicomponent lifestyle modification program was delivered weekly for 16 weeks by a trained health coach. This was followed by 8 weeks of passive follow-up resulting in a total trial duration of 24 weeks. Feasibility was determined by calculating study recruitment, retention, and adherence rates. Weight and components of metabolic syndrome (waist circumference, triglycerides (TG), high-density lipoprotein (HDL), serum glucose, and blood pressure (BP)) were measured at baseline, 12, and 24 weeks.
Recruitment, retention, and adherence rates were 47.1%, 90.3%, and 100%, respectively. Statistically significant improvements were noted between baseline and end of study measurements for weight (206.3 vs. 191.3 lbs, p < 0.001), waist (41.3 vs. 38.8 inches, p < 0.001), systolic BP (144.1 vs. 133.4 mm of Hg, p = 0.014), diastolic BP (83.3 vs. 76.2 mm of Hg, p = 0.0056), TG (146.0 vs. 113.8 mg/dl, p = 0.022), HDL (51.1 vs. 55.0 mg/dl, p = 0.012), and serum glucose (114.0 vs. 103.2 mg/dl, p = 0.013).
CLIPP demonstrates feasibility and early efficacy of a multicomponent lifestyle modification intervention toward addressing obesity as well as components of metabolic syndrome in men on ADT for prostate cancer. This study provides strong preliminary data to develop future clinical trials in this population.
前列腺癌的雄激素剥夺疗法(ADT)会引起不良反应,如肥胖和代谢综合征,这些会增加心血管风险,是确诊前列腺癌男性患者非癌症死亡的最常见原因。创建综合生活方式改善计划(CLIPP)是为了确定在接受 ADT 治疗的前列腺癌男性中进行全面生活方式改变干预的可行性,并确定其早期在减少肥胖和代谢综合征方面的疗效。
采用单臂、开放标签临床试验,招募了 31 名最近 5 年内被诊断患有前列腺癌且接受 ADT 治疗的男性。由经过培训的健康教练每周提供一次多成分生活方式改变方案,持续 16 周。随后是 8 周的被动随访,总试验持续时间为 24 周。通过计算研究招募、保留和依从率来确定可行性。在基线、12 周和 24 周时测量体重和代谢综合征的成分(腰围、三酰甘油(TG)、高密度脂蛋白(HDL)、血清葡萄糖和血压(BP))。
招募、保留和依从率分别为 47.1%、90.3%和 100%。与基线相比,研究结束时的测量值显示体重(206.3 磅与 191.3 磅,p<0.001)、腰围(41.3 英寸与 38.8 英寸,p<0.001)、收缩压(144.1 毫米汞柱与 133.4 毫米汞柱,p=0.014)、舒张压(83.3 毫米汞柱与 76.2 毫米汞柱,p=0.0056)、TG(146.0 毫克/分升与 113.8 毫克/分升,p=0.022)、HDL(51.1 毫克/分升与 55.0 毫克/分升,p=0.012)和血清葡萄糖(114.0 毫克/分升与 103.2 毫克/分升,p=0.013)均有显著改善。
CLIPP 证明了针对接受 ADT 治疗的前列腺癌男性的肥胖和代谢综合征成分的多成分生活方式改变干预的可行性和早期疗效。这项研究为该人群开展未来临床试验提供了强有力的初步数据。