Impact of New Generation Hormono-therapy on Cognitive Functions in Elderly Patients Treated for a Metastatic Prostate Cancer (COG-PRO)

Centre Francois Baclesse

Status

Completed

Conditions

Metastatic Castration-resistant Prostate Cancer (CRPCa)

Treatments

Other: neuropsychologic evaluation

Other: oncogeriatric evaluation

Study type

Interventional

Funder types

Other

Identifiers

NCT02907372

2016-001248-20

Details and patient eligibility

About

This study will assess the impact of the novel oral hormonal agents (abiraterone acetate or enzalutamide) among elderly metastatic prostate cancer patients. This study will assess the influence of treatments on patients' cognitive functions on a longitudinal basis and evaluate the quality of life and the adherence of patients who had or develop cognitive disorders.

Full description

In this new area of multiples new treatments in advanced PCa that could be proposed to elderly patients, evaluating, understanding and analysing the incidence, severity of cognitive dysfunctions and their impact on quality of life, autonomy and adherence among this group of vulnerable patients with advanced disease is a challenge and is essential to help clinicians taking care of their patients. As the deficits may be subtle and not always related with complaints, cognitive functions need to be assessed by objective sensitive neuropsychological tests and by patient-perceived cognitive self-report questionnaire. In addition to the treatments,there is a range of potential confounders that can contribute to cognitive impairment, such as co-medications, psychological factors (e.g. anxiety or depression), fatigue, or cognitive reserve (i.e. patients with higher education, more occupational attainment, or participation in leisure activities report less clinical or cognitive changes with aging.

The evaluation and the comprehension of the cognitive decline in patients treated for a cancer are complex and need a multidisciplinary approach in human sciences in strong link to clinicians and biologist researchers.

Therefore, this study propose an original unique comprehensive interdisciplinary approach at the interface between public health, clinical research, psychology and biology which would have a direct impact on cancer patient care, including a consortium of neuropsychologists, oncologists and biologist researchers who are working together within the North West canceropole "cognition and cancer" program. In evaluating cognitive functions, mood, quality of life and adherence to treatments, fully in the scope of the proposal, will help to improve our knowledge in this new field of research in human health among cancer patients with a direct impact for the physicians and the patients. The strength of this project is to propose (in complement to the study conducted among patients) a comprehensive approach including an animal model with behavioural tasks as recommended by the ICCTF (International Cognition and Cancer Task Force).

This study will be the first one to address the question of the impact of the novel oral hormonal agents among elderly metastatic prostate cancer patients. This study will assess the influence of treatments on patients' cognitive functions on a longitudinal basis and evaluate the quality of life and the adherence of patients who had or develop cognitive disorders.

Enrollment

163 patients

Sex

Male

Ages

70+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

For the group of patients of interest :

Patient must have a metastatic castration-resistant prostate cancer (CRPCa)
Patient must be 70 years and more
Performance Status 0-2
Patient must have not received chemotherapy except one line per Docetaxel for hormono-sensitive situation and which must be completed for a least 18 months before inclusion
Patient must have been already treated with first generation of androgen deprivation therapy
Patient must be asymptomatic or pauci-symptomatic (with pain control, Visual Analog Scale ≤ 3)
Patient must be candidate for a treatment by a new generation hormono-therapy (with abiraterone acetate or enzalutamide), in accordance to precautions of these treatments described in Summary Characteristics of Product and in combination with androgen deprivation therapy
Treatment with biphosphonates is authorized
No known brain metastasis
Patient must be at least on level 3 on school scale
Patient has signed informed consent

For the control group of patients :

Patient with metastatic prostate cancer without resistance to castration
Patient must be 70 years and more
Performance Status 0-2
Patient must have not received chemotherapy except one line per Docetaxel for hormono-sensitive situation and which must be completed for a least 18 months before inclusion
Patient must have already started the first generation of androgen deprivation therapy at least since 3 months
Patient must be asymptomatic or pauci-symptomatic (with pain control, Visual Analog Scale ≤ 3)
No known brain metastasis
Patient must be at least on level 3 on school scale
Patient has signed informed consent

For the control group of healthy volunteers:

Man
No history of cancer,
70-year old or more,
Health status consistent with the participation to the study
At least on level 3 on school scale
Signed informed consent

Exclusion criteria

For all participants (group of patients of interest, control group of patients and group of healthy volunteers):

No previous treatment with a new generation hormone therapy (abiraterone acetate or enzalutamide)
Neurological sequelae of (traumatic brain injury, stroke, multiple sclerosis, epilepsy, neuro-degenerative disease...)
Known evolutive psychiatric disorder
Drug use
Heavy drinking
Assessed to be unable or unwilling to comply with the requirements of the protocol

For group of patients of interest, additional non-inclusion criteria :