Sarcopenia during androgen-deprivation therapy for prostate cancer.
OBJECTIVE
To characterize changes in lean body mass (LBM) in men with prostate cancer receiving androgen-deprivation therapy (ADT).


METHODS
We prospectively evaluated LBM in a prespecified substudy of a randomized controlled trial of denosumab to prevent fractures in men receiving ADT for nonmetastatic prostate cancer. LBM was measured by total-body dual-energy x-ray absorptiometry at study baseline and at 12, 24, and 36 months. The analyses included 252 patients (132, denosumab; 120, placebo) with a baseline and at least one on-study LBM assessment. Patients were stratified by age (< 70 v ≥ 70 years) and by ADT duration (≤ 6 v > 6 months).


RESULTS
Median ADT duration was 20.4 months at study baseline. Mean LBM decreased significantly from baseline, by 1.0% at month 12 (95% CI, 0.4% to 1.5%; P < .001; n = 248), by 2.1% at month 24 (95% CI, 1.5% to 2.7%; P < .001; n = 205), and by 2.4% at month 36 (95% CI, 1.6% to 3.2%; P < .001; n = 168). Men age ≥ 70 years (n = 127) had significantly greater changes in LBM at all measured time points than younger men. At 36 months, LBM decreased by 2.8% in men age ≥ 70 years and by 0.9% in younger men (P = .035). Men with ≤ 6 months of ADT at study entry (n = 36) had a greater rate of decrease in LBM compared with men who had received more than 6 months of ADT at study entry (3.7% v 2.0%; P = .0645).


CONCLUSIONS
In men receiving ADT, LBM decreased significantly after 12, 24, and 36 months.
Massachusetts General Hospital Cancer Center, Yawkey 7030, 55 Fruit St, Boston, MA 02114, USA. smith.matthew@mgh.harvard.edu
Matthew R
MR
Smith
Fred
F
Saad
Blair
B
Egerdie
Paul R
PR
Sieber
Teuvo L J
TL
Tammela
Chunlei
C
Ke
Benjamin Z
BZ
Leder
Carsten
C
Goessl
D015502:Absorptiometry, Photon; D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects; D000069448:Denosumab; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D055948:Sarcopenia / Q000139:chemically induced*
D000726:Androgen Antagonists; D061067:Antibodies, Monoclonal, Humanized; D000069448:Denosumab