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Phase IV Study to Evaluate Bone Mineral Density in No-bone Metastatic Prostate Cancer Treated With Degarelix (BLADE)

Primary Purpose

Prostate Cancer

Status
Unknown status
Phase
Phase 4
Locations
Italy
Study Type
Interventional
Intervention
Degarelix
Sponsored by
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Prostate Cancer focused on measuring Androgen deprivation therapy, GnRH antagonist

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • male outpatients, aged 18 or older, willing and able to provide written informed consent;
  • histological diagnosis of prostate carcinoma;
  • more than 6-month survival prospect;
  • no bone metastases as assessed by bone scintigraphy;
  • eligibility to ADT with Degarelix in the opinion of the clinical investigator.

Exclusion Criteria:

  • patients with absolute or relative contraindication for prescription of Degarelix. In particular:
  • hypersensitivity towards any component of Firmagon®
  • patients who receive concomitant medications that might prolong the QT interval, in particular class I A (such as quinidine, procainamide, disopyramide,) or class III antiarrhythmics (such as amiodarone, sotalol, dofetilide, ibutilide)
  • patients with history of or risk factors for Torsades de Pointes
  • patients who take either methadone or moxifloxacin or antipsychotic
  • patients with alteration in electrolyte blood levels (such as sodium, potassium, calcium and magnesium)
  • patients with severe kidney and/or liver dysfunctions;
  • concomitant bone metabolic disease, such as Paget's disease, primary hyperparathyroidism or chronic hypercortisolism, as recorded by medical history;
  • renal failure (baseline serum creatinine more than 1.5 mg/dl);
  • prior hormonal treatment;
  • prior or concomitant treatment with bisphosphonates or other drugs known to affect bone metabolism (for example steroids, calcitonin);
  • patients participating in an interventional clinical trial in which any treatment or follow-up is mandated;

Sites / Locations

  • Clinical Department of Urology, university Hospital Spedali Civili di BresciaRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Degarelix

Arm Description

Outcomes

Primary Outcome Measures

Changes in fat body mass
To determine changes in fat body mass after 12 months Degarelix administration.

Secondary Outcome Measures

changes in bone mineral density
to assess changes in bone mineral density after 12 months of therapy;
changes in lean body mass
to assess changes in lean body mass after 12 months of therapy;
changes in fasting serum lipids
to assess changes in fasting serum lipids after 12 months of therapy;
changes in bone turn-over markers
to assess changes in bone turn-over markers after 12 months of therapy;
changes in insulin sensitivity
to assess changes in insulin sensitivity after 12 months of therapy;
changes in serum follicle stimulating hormone (FSH) levels
to assess changes in serum FSH levels after 12 months of therapy;

Full Information

First Posted
June 12, 2017
Last Updated
June 27, 2017
Sponsor
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
Collaborators
Ferring Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03202381
Brief Title
Phase IV Study to Evaluate Bone Mineral Density in No-bone Metastatic Prostate Cancer Treated With Degarelix
Acronym
BLADE
Official Title
A Pilot Phase IV Study to Evaluate Variation in Bone Mineral Density, Lean and Fat Body Mass Index Measured by Dual-energy X-ray Absorptiometry in Patients With Prostate Cancer Without Bone Metastasis Treated With Degarelix
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Unknown status
Study Start Date
June 26, 2017 (Actual)
Primary Completion Date
March 2019 (Anticipated)
Study Completion Date
March 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
Collaborators
Ferring Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
The aim of this phase IV interventional study is to evaluate variation in bone mineral density and lean and fat body composition in patients with prostate cancer without bone metastasis, treated with Degarelix. These variations are evaluated at time 0 (before starting androgen deprivation therapy with Degarelix) and after 12 months of therapy by dual-energy X-ray absorptiometry (DXA scan).
Detailed Description
Gonadotropin-releasing hormone (GnRH) agonists decrease bone mineral density (BMD) and increase fracture risk in men with prostate carcinoma. GnRH agonists also increase fat mass and decrease lean body mass. These treatment-related changes in body composition may contribute to fatigue, emotional distress, and decreased quality of life. Whereas the consequences of initial GnRH agonist on BMD and body composition are well characterized, less is known regarding the effects of GnRH antagonists. At the best of our knowledge the changes in body composition induced by Degarelix in prostate cancer patients has never been explored. Dual-energy X-ray absorptiometry (DXA) is a reliable and accurate method to determine the changes in body composition in patients with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT). The change in body composition is a major determinant of increased morbidity and mortality induced by ADT and DXA provides the most precise measure of body composition. This study is designed to obtain explorative information on changes in bone mineral density, fat body mass and lean body mass by DXA scan after administration of Degarelix. These preliminary data compared with historical data of patients submitted to GnRH agonists could provide a rationale for a subsequent prospective randomized clinical trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
Androgen deprivation therapy, GnRH antagonist

7. Study Design

Primary Purpose
Other
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
35 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Degarelix
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Degarelix
Intervention Description
Degarelix (Firmagon®) will be administered as a subcutaneous injection in the abdominal region every 28 days, in according to the following schedule: Starting dose: 240 mg administered as two consecutive subcutaneous injections of 120 mg each (2 x 3 mL injections). Maintenance dose: 80 mg administered as one subcutaneous injection of 80 mg (1 x 4 mL injection). Treatment will be continued till clinically indicated or till disease progression.
Primary Outcome Measure Information:
Title
Changes in fat body mass
Description
To determine changes in fat body mass after 12 months Degarelix administration.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
changes in bone mineral density
Description
to assess changes in bone mineral density after 12 months of therapy;
Time Frame
12 months
Title
changes in lean body mass
Description
to assess changes in lean body mass after 12 months of therapy;
Time Frame
12 months
Title
changes in fasting serum lipids
Description
to assess changes in fasting serum lipids after 12 months of therapy;
Time Frame
12 months
Title
changes in bone turn-over markers
Description
to assess changes in bone turn-over markers after 12 months of therapy;
Time Frame
12 months
Title
changes in insulin sensitivity
Description
to assess changes in insulin sensitivity after 12 months of therapy;
Time Frame
12 months
Title
changes in serum follicle stimulating hormone (FSH) levels
Description
to assess changes in serum FSH levels after 12 months of therapy;
Time Frame
12 months

10. Eligibility

Sex
Male
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: male outpatients, aged 18 or older, willing and able to provide written informed consent; histological diagnosis of prostate carcinoma; more than 6-month survival prospect; no bone metastases as assessed by bone scintigraphy; eligibility to ADT with Degarelix in the opinion of the clinical investigator. Exclusion Criteria: patients with absolute or relative contraindication for prescription of Degarelix. In particular: hypersensitivity towards any component of Firmagon® patients who receive concomitant medications that might prolong the QT interval, in particular class I A (such as quinidine, procainamide, disopyramide,) or class III antiarrhythmics (such as amiodarone, sotalol, dofetilide, ibutilide) patients with history of or risk factors for Torsades de Pointes patients who take either methadone or moxifloxacin or antipsychotic patients with alteration in electrolyte blood levels (such as sodium, potassium, calcium and magnesium) patients with severe kidney and/or liver dysfunctions; concomitant bone metabolic disease, such as Paget's disease, primary hyperparathyroidism or chronic hypercortisolism, as recorded by medical history; renal failure (baseline serum creatinine more than 1.5 mg/dl); prior hormonal treatment; prior or concomitant treatment with bisphosphonates or other drugs known to affect bone metabolism (for example steroids, calcitonin); patients participating in an interventional clinical trial in which any treatment or follow-up is mandated;
Facility Information:
Facility Name
Clinical Department of Urology, university Hospital Spedali Civili di Brescia
City
Brescia
ZIP/Postal Code
25123
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alessandro Antonelli, MD
Phone
+39 030 3995215
Email
alessandro_antonelli@me.com
First Name & Middle Initial & Last Name & Degree
Carlotta Palumbo, MD
Phone
+39 030 3995215
Email
palumbo.carlotta@gmail.com

12. IPD Sharing Statement

Citations:
PubMed Identifier
15072892
Citation
Smith MR. Changes in fat and lean body mass during androgen-deprivation therapy for prostate cancer. Urology. 2004 Apr;63(4):742-5. doi: 10.1016/j.urology.2003.10.063.
Results Reference
background
PubMed Identifier
7539852
Citation
Eri LM, Urdal P, Bechensteen AG. Effects of the luteinizing hormone-releasing hormone agonist leuprolide on lipoproteins, fibrinogen and plasminogen activator inhibitor in patients with benign prostatic hyperplasia. J Urol. 1995 Jul;154(1):100-4.
Results Reference
background
PubMed Identifier
11836291
Citation
Smith MR, Finkelstein JS, McGovern FJ, Zietman AL, Fallon MA, Schoenfeld DA, Kantoff PW. Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab. 2002 Feb;87(2):599-603. doi: 10.1210/jcem.87.2.8299.
Results Reference
background
PubMed Identifier
12465755
Citation
Smith MR. Osteoporosis and other adverse body composition changes during androgen deprivation therapy for prostate cancer. Cancer Metastasis Rev. 2002;21(2):159-66. doi: 10.1023/a:1020840311573.
Results Reference
background
PubMed Identifier
16434464
Citation
Smith MR, Lee H, Nathan DM. Insulin sensitivity during combined androgen blockade for prostate cancer. J Clin Endocrinol Metab. 2006 Apr;91(4):1305-8. doi: 10.1210/jc.2005-2507. Epub 2006 Jan 24.
Results Reference
background
PubMed Identifier
11992038
Citation
Berruti A, Dogliotti L, Terrone C, Cerutti S, Isaia G, Tarabuzzi R, Reimondo G, Mari M, Ardissone P, De Luca S, Fasolis G, Fontana D, Rossetti SR, Angeli A; Gruppo Onco Urologico Piemontese (G.O.U.P.), Rete Oncologica Piemontese. Changes in bone mineral density, lean body mass and fat content as measured by dual energy x-ray absorptiometry in patients with prostate cancer without apparent bone metastases given androgen deprivation therapy. J Urol. 2002 Jun;167(6):2361-7; discussion 2367.
Results Reference
background
PubMed Identifier
25588772
Citation
Buttigliero C, Vana F, Bertaglia V, Vignani F, Fiori C, Osella G, Porpiglia F, Tucci M, Scagliotti GV, Berruti A. The fat body mass increase after adjuvant androgen deprivation therapy is predictive of prostate cancer outcome. Endocrine. 2015 Sep;50(1):223-30. doi: 10.1007/s12020-015-0525-x. Epub 2015 Jan 15.
Results Reference
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Phase IV Study to Evaluate Bone Mineral Density in No-bone Metastatic Prostate Cancer Treated With Degarelix

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