Prostate Cancer: Multidisciplinary Clinic Feasible for Mitigating Toxicities

Participation in a multidisciplinary clinic is feasible for mitigating treatment-related toxicity among patients with newly diagnosed metastatic prostate cancer undergoing chemohormonal therapy, according to a study presented at the 2017 Cancer Survivorship Symposium.¹

Although chemohormonal therapy is the standard of care for newly diagnosed patients with metastatic prostate cancer, treatment is associated with significant toxicity, including negative metabolic changes. Researchers at the University of California, San Francisco, investigated the impact of participation in a multidisciplinary clinic on treatment-related adverse events.

For the pilot study, investigators enrolled 7 patients with recently diagnosed metastatic prostate cancer who were about to begin or recently initiated chemohormonal therapy. All patients had extensive disease at the time of enrollment and all had completed 6 cycles of docetaxel-based chemotherapy, with continued hormone therapy for the duration of the study.

Participants attended the multidisciplinary clinic monthly, which included individualized counseling from a physical therapist, oncology dietician, and palliative care specialist on a rotating basis for 12 months. Investigators evaluated changes in body fat, weight, serum levels of 25-OH vitamin D, fasting lipids, glucose, insulin, and quality of life every 4 months. Patients also underwent DXA bone density scans at baseline and at the end of 12 months.

Patients completed 98% of the 55 total planned visits. Eighty-one percent completed all assessments, including quality of life questionnaires. There were no skeletal-related complications.

Body weight and body fat percentage increased by 3.51% and 20% from baseline, respectively.

An open-label, randomized, phase 2 trial (ClinicalTrials.gov Identifier: NCT02168062) is recruiting patients to evaluate the impact of the multidisciplinary clinic on changes in key metabolic parameters, quality of life, and patient satisfaction among men receiving androgen deprivation therapy for prostate cancer. A separate non-randomized patient cohort will assess the benefit of the clinic in patients receiving concurrent chemohormonal therapy.

Reference

1. Hough J, Rodvelt TJ, Thomas M, et al. A multidisciplinary clinic to mitigate the toxicity of therapy for newly diagnosed metastatic prostate cancer undergoing chemohormonal therapy: A feasibility study. J Clin Oncol. 2017;35(suppl):5S. Abstract 153.