Comprehensive lifestyle improvement program for prostate cancer (CLIPP): Protocol for a feasibility and exploratory efficacy study in men on androgen deprivation therapy

Amit Algotar, Chiu-Hsieh Hsu, Hsiao-Hui Chow, Shona Dougherty, Hani M. Babiker, David Marrero, Ivo L Abraham, Rachit Kumar, Jennifer Ligibel, Kerry S. Courneya, Cynthia Thomson

Research output: Contribution to journalArticle

Abstract

Background: Androgen deprivation therapy (ADT) for prostate cancer is associated with adverse cardiometabolic effects such as reduced libido, hot flashes, metabolic syndrome, diabetes, myocardial infarction, and stroke. This reduces quality of life and potentially increases mortality. Several large clinical trials have demonstrated improvements in cardiometabolic risk with comprehensive multimodality lifestyle modification. However, there is a lack of data for such interventions in men on ADT for prostate cancer, and existing studies have used non-standardized interventions or lacked data on metabolic risk factors. Objective: The Comprehensive Lifestyle Improvement Project for Prostate Cancer (CLIPP) is designed to address these gaps by using an intervention modeled on the Diabetes Prevention Program, a standardized multicomponent intervention with demonstrated effectiveness in reducing cardiometabolic risk factors that has been successfully adapted for multiple disease types including breast cancer. Methods: A single-arm unblinded clinical trial will be conducted to determine the feasibility of conducting a 24-week comprehensive lifestyle modification intervention that targets weight loss and increased physical activity modeled on the Diabetes Prevention Program in 30 men on ADT for prostate cancer. Secondary aims are to determine the effect of the intervention on cardiometabolic markers and quality of life. The tertiary aim is to determine the effect of the intervention on markers of inflammation and angiogenesis, important mechanisms for prostate cancer progression. Participants will be recruited from the University of Arizona Cancer Center and the surrounding community. The intervention will be delivered weekly in person and over the phone for 16 weeks. For Weeks 16-24, participants receive weekly phone calls from the study health coach to motivate them to continue their lifestyle modification. Questionnaire and biological data are collected at baseline, 12 weeks, and 24 weeks. Body composition using dual-energy x-ray absorptiometry scans will be performed at baseline and end of study. Results: Based on a sample size of 30, the two-sided 95% confidence interval will not be wider than 0.373 standard deviations for the adherence rate and will not be wider than 0.374 for the retention rate. In addition, the study will have a power of 80% to detect a change of 0.47 standard deviations from baseline for each of the markers investigated in the secondary and tertiary aims assuming a within-subject correlation of 0.20 at a significance level of 5%. The recruitment period is from October 2018 to April 2019. Conclusions: The aim of CLIPP is to determine the feasibility of conducting a Diabetes Prevention Program–style comprehensive lifestyle modification intervention in men with ADT for prostate cancer and its effects on cardiometabolic adverse effects, quality of life, as well as markers of inflammation and angiogenesis. Results will inform the development of future clinical trials in this population.

Original languageEnglish (US)
Article numbere12579
JournalJournal of medical Internet research
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2019

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Androgens
Life Style
Prostatic Neoplasms
Quality of Life
Clinical Trials
Therapeutics
Hot Flashes
Inflammation
Libido
Body Composition
Sample Size
Weight Loss
Stroke
Myocardial Infarction
X-Rays
Confidence Intervals
Exercise
Breast Neoplasms
Mortality
Health

Keywords

  • Androgen deprivation therapy
  • Lifestyle modification
  • Prostate cancer
  • Quality of life

ASJC Scopus subject areas

  • Health Informatics

Cite this

Comprehensive lifestyle improvement program for prostate cancer (CLIPP) : Protocol for a feasibility and exploratory efficacy study in men on androgen deprivation therapy. / Algotar, Amit; Hsu, Chiu-Hsieh; Chow, Hsiao-Hui; Dougherty, Shona; Babiker, Hani M.; Marrero, David; Abraham, Ivo L; Kumar, Rachit; Ligibel, Jennifer; Courneya, Kerry S.; Thomson, Cynthia.

In: Journal of medical Internet research, Vol. 21, No. 2, e12579, 01.02.2019.

Research output: Contribution to journalArticle

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abstract = "Background: Androgen deprivation therapy (ADT) for prostate cancer is associated with adverse cardiometabolic effects such as reduced libido, hot flashes, metabolic syndrome, diabetes, myocardial infarction, and stroke. This reduces quality of life and potentially increases mortality. Several large clinical trials have demonstrated improvements in cardiometabolic risk with comprehensive multimodality lifestyle modification. However, there is a lack of data for such interventions in men on ADT for prostate cancer, and existing studies have used non-standardized interventions or lacked data on metabolic risk factors. Objective: The Comprehensive Lifestyle Improvement Project for Prostate Cancer (CLIPP) is designed to address these gaps by using an intervention modeled on the Diabetes Prevention Program, a standardized multicomponent intervention with demonstrated effectiveness in reducing cardiometabolic risk factors that has been successfully adapted for multiple disease types including breast cancer. Methods: A single-arm unblinded clinical trial will be conducted to determine the feasibility of conducting a 24-week comprehensive lifestyle modification intervention that targets weight loss and increased physical activity modeled on the Diabetes Prevention Program in 30 men on ADT for prostate cancer. Secondary aims are to determine the effect of the intervention on cardiometabolic markers and quality of life. The tertiary aim is to determine the effect of the intervention on markers of inflammation and angiogenesis, important mechanisms for prostate cancer progression. Participants will be recruited from the University of Arizona Cancer Center and the surrounding community. The intervention will be delivered weekly in person and over the phone for 16 weeks. For Weeks 16-24, participants receive weekly phone calls from the study health coach to motivate them to continue their lifestyle modification. Questionnaire and biological data are collected at baseline, 12 weeks, and 24 weeks. Body composition using dual-energy x-ray absorptiometry scans will be performed at baseline and end of study. Results: Based on a sample size of 30, the two-sided 95{\%} confidence interval will not be wider than 0.373 standard deviations for the adherence rate and will not be wider than 0.374 for the retention rate. In addition, the study will have a power of 80{\%} to detect a change of 0.47 standard deviations from baseline for each of the markers investigated in the secondary and tertiary aims assuming a within-subject correlation of 0.20 at a significance level of 5{\%}. The recruitment period is from October 2018 to April 2019. Conclusions: The aim of CLIPP is to determine the feasibility of conducting a Diabetes Prevention Program–style comprehensive lifestyle modification intervention in men with ADT for prostate cancer and its effects on cardiometabolic adverse effects, quality of life, as well as markers of inflammation and angiogenesis. Results will inform the development of future clinical trials in this population.",
keywords = "Androgen deprivation therapy, Lifestyle modification, Prostate cancer, Quality of life",
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AU - Hsu, Chiu-Hsieh

AU - Chow, Hsiao-Hui

AU - Dougherty, Shona

AU - Babiker, Hani M.

AU - Marrero, David

AU - Abraham, Ivo L

AU - Kumar, Rachit

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KW - Lifestyle modification

KW - Prostate cancer

KW - Quality of life

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