Castration-resistant Prostate Cancer Clinical Trial
Official title:
Evaluation of Cardiotoxicity and Hypertension in Patients With Non Metastatic Castration Resistant Prostatic Carcinoma
This is a prospective observational study on a cohort of patients with castration-resistant
prostate cancer M0, treated with Apalutamide, at the Oncology Unit of the "Andrea Tortora"
Hospital of Pagani. Data will be collected on the patient's clinical history and the
treatments carried out until the start of therapy with Apalutamide. At that time the study
will be described to the patient and informed consent will be given.
In case of a favorable opinion from the patient, the CRF will be filled in. Patients with
CRPC M0 treated with Apalutamide, belonging to the Oncology Unit of the Pagani Hospital
"Andrea Tortora" and of the other Oncology Units of the ASL of Salerno (Hospital of Vallo
della Lucania) will be studied with the possibility of enrollment also from other Centers
outside the Salerno ASL.
The CRPC M0 patient will be identified by PET PSMA, or CT scan and Bone Scanning at the
clinician's discretion based on the physical examination performed at the patient's first
access. The reassessment of the disease status is to be repeated by PET-PSMA, CT scan or bone
scan (in relation to the examination carried out at baseline) in a period of time ranging
from 6 to 12 months after the first access, based on the assessment of the health status of
the patient and tolerability to treatment after careful evaluation by the clinician. The
blood chemistry routine including CBC with white blood cell formula will be repeated every 30
days. The patient will be provided with a blood pressure monitoring diary every 30 days. The
measurement of cardiac markers will be performed every 60 days. The evaluation of the
cardiological function will be carried out by means of ECG, echocardiography with
determination of the LVEF, 24-hour Holter blood pressure every 6 months. Bone mineral density
assessment will be monitored by MOC-DEXA every 6 months. Possible drug interactions with
Apalutamide will be identified.
Primary objective:
-Evaluation of arterial hypertension, by periodic measurement of blood pressure every week
(1-3 times), creation of a weekly blood pressure diary, 24-hour blood pressure holter every
six months, with stratification of patients under treatment according to the degree of AI
found.
Secondary objectives:
- Evaluation of cardiological toxicity, through the execution of ECG, periodic
echocardiography for the evaluation of the ejection fraction of the left ventricle,
cardiac markers (troponin, CK-MB, pro-BNP)
- Assessment of the biochemical response, such as a 50% reduction in total PSA compared to
baseline in patients receiving apalutamide;
- Evaluation of the change in blood chemistry parameters in the patient being treated with
Apalutamide;
- Relationship between changes in blood chemistry parameters and time to the onset of
metastases, assessed by PET PSMA or bone scan or CT scan;
- Relationship between changes in blood chemistry parameters and overall survival;
- Relationship between changes in blood chemistry parameters and occurrence of serious
adverse events;
- Association between basophil counts and appearance of skin rash;
- Evaluation of drug interactions with Apalutamide.
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