ASCO GU 2018: Effects Of a 6-month Moderate-intensity Exercise Program on Metabolic Parameters and Bone Mineral Density in Men on Androgen Deprivation Therapy for Prostate Cancer

San Francisco, CA (UroToday.com) Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer (PC) but is associated with significant side effects including metabolic abnormalities and bone loss. Although multiple trials have demonstrated that exercise is associated with improvements in associated multiple side effects caused by ADT, its effects on metabolic and skeletal outcomes is unclear. The authors conducted a phase II randomized controlled trial (RCT) comparing three different exercise delivery models. The presented analysis examined prespecified endpoints of change in metabolic parameters and bone mineral density.

Methods:
Men with PC starting or continuing ADT for at least 6 months were enrolled and randomized equally to personal training (n = 18), supervised group training (n = 14), or home-based training (n = 16). Participants in all intervention arms underwent moderate to vigorous physical activity with a target of 150 minutes per week for 6 months. Fasting blood work and dual x-ray absorptiometry (DXA) were performed at baseline and at 6 months (blood work) and 12 months (DXA).

Results:
A total of 48 participants (mean age 69.9 years) were enrolled. The primary analysis demonstrated no significant difference between arms on most quality of life and fitness outcomes, therefore these groups were combined for the present analysis. Exercise was not associated with statistically significant changes in hemoglobin, total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, or fasting blood glucose (p = 0.075 to 0.87). Similarly, exercise was not associated with changes in bone mineral density at lumbar spine, total hip, or femoral neck sites on DXA (p = 0.44 to 0.71). Mean weight change was +0.8 kg. There was no difference between exercise arms on any outcome.

Conclusions:
Although this study is limited by a small sample size, the results suggest that 6 months of moderate intensity exercise is not associated with improvements in both metabolic and skeletal outcomes in men on ADT. More intensive behavioral interventions and/or pharmacological interventions are probably needed to reverse the deleterious effects of ADT. Clinical trial information: NCT02046837

Presented by: Shabbir M.H. Alibhai

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Twitter:@GoldbergHanan at the 2018 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, February 8-10, 2018 - San Francisco, CA
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