High-Dose Vitamin D Supplementation for ADT-Induced Bone Loss in Older Prostate Cancer Patients

University of Rochester NCORP Research Base

Status and phase: Enrolling; Phase 3

Conditions: Stage I Prostate Cancer AJCC v8; Stage IVA Prostate Cancer AJCC v8; Stage III Prostate Cancer AJCC v8; Stage II Prostate Cancer AJCC v8

Treatments: Other: Questionnaire Administration; Procedure: Dual X-ray Absorptiometry; Drug: Placebo Administration; Other: Quality-of-Life Assessment; Procedure: Biospecimen Collection; Dietary Supplement: D Vitamin

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05838716

UG1CA189961 (U.S. NIH Grant/Contract)

NCI-2022-07664 (Registry Identifier)

URCC-22053 (Other Identifier)

R01CA258349 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This phase III trial tests whether high-dose vitamin D works in treating androgen-deprivation therapy (ADT)-induced bone loss in patients with prostate cancer who are undergoing androgen-deprivation therapy. Vitamins are substances that the body needs to grow and develop normally. Vitamin D helps the body absorb calcium. Calcium is one of the main building blocks of bone. A lack of vitamin D can lead to bone diseases such as osteoporosis or rickets. This trial may help researchers determine if high-dose vitamin D helps keep bones strong, lowers number of falls, and lessens fatigue in men getting androgen-deprivation therapy.

Full description

PRIMARY OBJECTIVES:

I. To evaluate the effect of high-dose vitamin D (HDVD) supplementation in prostate cancer patients on ADT-induced bone mineral density loss in the total hip over 52 weeks as measured by dual-energy x-ray absorptiometry (DXA).

II. To evaluate the effect of HDVD supplementation in prostate cancer patients on ADT-induced bone mineral density loss in the femoral neck, distal radius, and lumbar spine (L1-L4) over 52 weeks as measured by DXA.

SECONDARY OBJECTIVES:

I. To evaluate the effect of HDVD supplementation on falls over 52 weeks as measured by the Falls History questionnaire.

II. To evaluate the effect of HDVD supplementation on fractures over 52 weeks as determined by the Clinical Record Information - Follow-up Form.

III. To evaluate the effect of HDVD supplementation on quality of life over 52 weeks as measured by the Functional Assessment of Cancer Therapy- Prostate (FACT-P).

EXPLORATORY OBJECTIVES:

I. To explore the effect of HDVD supplementation on bone biomarkers measured by Millipore Luminex/enzyme-linked immunosorbent assay (ELISA) assays from serum.

II. To evaluate the effect of HDVD supplementation on pain, fatigue, sleep, and activities of daily living over 52 weeks as measured by patient-reported outcomes.

OUTLINE: After undergoing collection of blood and DXA scan, patients are randomized to 1 of 2 arms.

ARM I: Patients receive HDVD orally (PO) once a week (QW) for 52 weeks. Patients also undergo collection of blood and DXA scan on study.

ARM II: Patients receive placebo PO QW for 52 weeks. Patients also undergo collection of blood and DXA scan on study.

Enrollment: 366 estimated patients

Sex: Male

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Be diagnosed with Stage I-IV prostate cancer without metastases to bone (lymph node involvement and prior diagnosis of a primary cancer is allowed)
• Be age 60 years or older
• Be starting ADT or have received their first ADT treatment in the past 3 months, with a total of at least 6 planned months of treatment (both luteinizing hormone-releasing hormone [LHRH] antagonists and LHRH agonists are permitted)
• Have a total serum vitamin D between 10 and 27 ng/ml
• Have a total serum calcium of less than or equal to 10.5 mg/dl
• Have a normal GFR (glomerular filtration rate > 30ml)
• Agree not to take calcium and/or vitamin D supplements for the duration of the intervention other than those provided by the study
• Be able to provide written informed consent
• Be able to swallow pills and capsules
• Be able to speak and read English

Exclusion criteria

• Have long term (greater than 3 months) use of any pharmacologic bone-modifying agent including but not limited to oral or intravenous (IV) bisphosphonates, denosumab, or teriparatide prior to enrollment
• Have a diagnosis of stage IV chronic kidney disease
• Have a diagnosis of grade II or greater hypercalcemia (serum calcium greater than 11.5 mg/dl)
• Have a history of hypercalcemia or vitamin D toxicity/sensitivity

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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366 participants in 2 patient groups, including a placebo group

Arm I (HDVD)

Experimental group

Description:

Patients receive HDVD PO QW for 52 weeks. Patients also undergo collection of blood and DXA scan on study.

Treatment:

Dietary Supplement: D Vitamin

Procedure: Biospecimen Collection

Other: Quality-of-Life Assessment

Other: Questionnaire Administration

Procedure: Dual X-ray Absorptiometry

Arm II (placebo)

Placebo Comparator group

Description:

Patients receive placebo PO QW for 52 weeks. Patients also undergo collection of blood and DXA scan on study.

Treatment:

Procedure: Biospecimen Collection

Other: Quality-of-Life Assessment

Other: Questionnaire Administration

Drug: Placebo Administration

Procedure: Dual X-ray Absorptiometry