Vitamin D for Prostate Endocrine Therapy

Official title

High-dose Vitamin D Supplementation for ADT-Induced Bone Loss in Older Prostate Cancer Patients

Overview

This phase III trial tests whether high-dose vitamin D works in treating androgen-deprivation therapy (ADT)-induced bone loss in patients with prostate cancer who are undergoing androgen-deprivation therapy. Vitamins are substances that the body needs to grow and develop normally. Vitamin D helps the body absorb calcium. Calcium is one of the main building blocks of bone. A lack of vitamin D can lead to bone diseases such as osteoporosis or rickets. This trial may help researchers determine if high-dose vitamin D helps keep bones strong, lowers number of falls, and lessens fatigue in men getting androgen-deprivation therapy.

Detailed description

PRIMARY OBJECTIVES:

I. To evaluate the effect of high-dose vitamin D (HDVD) supplementation in prostate cancer patients on ADT-induced bone mineral density loss in the total hip over 52 weeks as measured by dual-energy x-ray absorptiometry (DXA).

II. To evaluate the effect of HDVD supplementation in prostate cancer patients on ADT-induced bone mineral density loss in the femoral neck, distal radius, and lumbar spine (L1-L4) over 52 weeks as measured by DXA.

SECONDARY OBJECTIVES:

I. To evaluate the effect of HDVD supplementation on falls over 52 weeks as measured by the Falls History questionnaire.

II. To evaluate the effect of HDVD supplementation on fractures over 52 weeks as determined by the Clinical Record Information - Follow-up Form.

III. To evaluate the effect of HDVD supplementation on quality of life over 52 weeks as measured by the Functional Assessment of Cancer Therapy- Prostate (FACT-P).

EXPLORATORY OBJECTIVE:

I. To evaluate the effect of HDVD supplementation on pain, fatigue, sleep, and activities of daily living over 52 weeks as measured by patient-reported outcomes.

OUTLINE: After undergoing collection of blood and DXA scan, patients are randomized to 1 of 2 arms.

ARM I: Patients receive HDVD orally (PO) once a week (QW) for 52 weeks. Patients also undergo collection of blood and DXA scan on study.

ARM II: Patients receive placebo PO QW for 52 weeks. Patients also undergo collection of blood and DXA scan on study.

Interventions

• Procedure Biospecimen Collection
  Undergo collection of blood
• Dietary supplement D Vitamin
  Given PO
• Procedure Dual X-ray Absorptiometry
  Undergo DXA scan
• Drug Placebo Administration
  Given PO
• Other Quality-of-Life Assessment
  Ancillary studies
• Other Questionnaire Administration
  Ancillary studies

Primary outcome measures

• Reduction of bone mineral density (BMD) loss as measured at the total hip [Time frame: At 52 weeks]
• Reduction of BMD loss as measured at the femoral neck [Time frame: At 52 weeks]
• Reduction of BMD loss as measured at the distal radius [Time frame: At 52 weeks]
• Reduction of BMD loss as measured at the lumbar spine [Time frame: At 52 weeks]

Secondary outcome measures (3)

• Change in falls [Time frame: Baseline up to 52 weeks]
• Change in fractures [Time frame: Baseline up to 52 weeks]
• Change in quality of life [Time frame: Baseline up to 52 weeks]

Eligibility criteria

Inclusion criteria

• Be diagnosed with Stage I-IV prostate cancer without metastases to bone (lymph node involvement and prior diagnosis of a primary cancer is allowed)
• Be age 50 years or older
• Be starting ADT or have received their first ADT treatment in the past 6 months, with a total of at least 6 planned months of treatment (both luteinizing hormone-releasing hormone \[LHRH\] antagonists and LHRH agonists are permitted)
• Have a total serum vitamin D between 10 and 32 ng/ml
• Have a total serum calcium of less than or equal to 10.5 mg/dl
• Have a normal GFR (glomerular filtration rate > 30ml)
• Agree not to take calcium and/or vitamin D supplements for the duration of the intervention other than those provided by the study
• Be able to provide written informed consent
• Be able to swallow pills and capsules
• Be able to speak and read English

Exclusion criteria

• Have long term (greater than 3 months) use of any pharmacologic bone-modifying agent including but not limited to oral or intravenous (IV) bisphosphonates, denosumab, or teriparatide prior to enrollment
• Have a diagnosis of stage IV chronic kidney disease
• Have a diagnosis of grade II or greater hypercalcemia (serum calcium greater than 11.5 mg/dl)
• Have a history of hypercalcemia or vitamin D toxicity/sensitivity

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Quadruple blind

Primary purpose

Supportive care

Study locations

United States · 51 centers

• Helen F Graham Cancer Center — Newark
• Medical Oncology Hematology Consultants PA — Newark
• Carle at The Riverfront — Danville
• Cancer Care Specialists of Illinois - Decatur — Decatur
• Carle Physician Group-Effingham — Effingham
• Carle Physician Group-Mattoon/Charleston — Mattoon
• Cancer Care Center of O'Fallon — O'Fallon
• Carle Cancer Center — Urbana
• … and 43 more centers

Identifiers

NCT: NCT05838716 · URCC-22053 · NCI-2022-07664 · URCC-22053 · URCC-22053 · URCC-22053 · R01CA258349 · UG1CA189961

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗