Adenocarcinoma of the Prostate Clinical Trial
Official title:
Phase II Placebo Controlled Trial of Preoperative Lycopene Supplementation in Prostate Cancer Patients
This randomized phase II trial studies how well different doses of lycopene work in treating patients undergoing radical prostatectomy for prostate cancer. The use of lycopene, a substance found in tomatoes, may keep prostate cancer from growing or coming back after surgery.
PRIMARY OBJECTIVES:
I. Compare the differences in tissue concentrations of lycopene in patients with prostate
cancer undergoing radical prostatectomy treated with different doses of neoadjuvant lycopene
supplementation.
II. Compare the change in serum lycopene concentration from baseline and at 4-7 weeks in
patients treated with different doses of lycopene.
SECONDARY OBJECTIVES:
I. Determine the effect of this treatment in down-regulating 5-alpha-reductase activity by
measuring the change in the ratio of testosterone (T) to dihydrotestosterone (DHT) in serum
at baseline and at 4-7 weeks and the ratio of T:DHT in prostatic surgical tissue
post-treatment.
II. Determine the effect of this treatment in attenuating baseline blood serum concentrations
of total prostate-specific antigen (PSA), free PSA, and human kallikrein 2 in these patients.
III. Determine the effect of this treatment on growth potential by examining post-treatment
radical prostatectomy tissue specimens for proliferative index (PI) by Ki-67 expression,
apoptotic index (AI) by TUNEL assay, and PI:AI ratio in these patients.
IV. Determine the effect of this treatment in modulating putative biomarkers of lycopene
efficacy, including serum concentrations of insulin-like growth factor (IGF)-1 and IGF
binding protein-3, lymphocyte oxidative DNA damage capacity by Comet assay, and GST-pi
expression in prostatic tissue from these patients.
V. Compare the histological effect of different doses of lycopene on putative prognostic
features, including the presence and extent of high-grade prostatic intraepithelial
neoplasia, prostatitis, total tumor volume, local invasion (vascular and lymphatic, capsular,
seminal vesicle), pathologic stage, Gleason score, surgical margins, and lymph node status in
these patients.
VI. Determine the effect of this treatment in modulating the RNA expression of
androgen-related genes by microarray analysis in these patients.
OUTLINE:
This is a randomized, placebo-controlled, double-blind, multicenter study. Patients are
stratified according to participating center. Patients are randomized to 1 of 3 treatment
arms.
ARM I: Patients receive placebo orally (PO) once daily (QD) for 4-7 weeks, and then undergo
radical prostatectomy.
ARM II: Patients receive low-dose lycopene PO QD for 4-7 weeks, and then undergo radical
prostatectomy.
ARM III: Patients receive high-dose lycopene PO QD for 4-7 weeks, and then undergo radical
prostatectomy.
Tumor samples are collected from prostatectomy for laboratory studies, including GST-pi
expression by immunohistochemistry; histological analysis; microarray analysis of
androgen-related genes; ratio of testosterone (T) to dihydrotestosterone (DHT); Ki-67
expression; and lycopene tumor-concentration measurement.
Patients undergo blood collection at baseline, week 4, and week 7 for laboratory studies,
including serum lycopene concentration measurement; level of T or DHT by high-performance
liquid chromatography/tandem mass spectrometry (HPLC/MS/MS) analysis; serum concentrations of
total prostate-specific antigen (PSA), free PSA, and human kallikrein 2; lymphocyte oxidative
DNA damage capacity; and serum concentrations of insulin-like growth factor (IGF)-1 and IGF
binding protein-3 by radioimmunological assay.
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