Creatine supplementation and resistance training to preserve muscle mass and attenuate cancer progression (CREATINE-52): a protocol for a double-blind randomized controlled trial

• Published in: BMC cancer 2024-04, Vol.24 (1), p.493-11, Article 493
• Main Authors: Coletta, Adriana M, Simon, Lea Haverbeck, Maslana, Kelsey, Taylor, Sarah, Larson, Kish, Hansen, Pamela A, Thomas, Vinay Mathew, Ulrich, Cornelia M, Kohli, Manish, Chipman, Jonathan, Swami, Umang, Gupta, Sumati, Maughan, Benjamin L, Agarwal, Neeraj
• Format: Article
• Language: English
• Subjects: Aged; Androgen Antagonists - therapeutic use; Androgens; Body Composition; Cancer therapies; Care and treatment; Castration; Clinical trial; Clinical trials; Creatine; Creatine - pharmacology; Creatine - therapeutic use; Creatine monohydrate; Development and progression; Dietary Supplements - adverse effects; Dosage and administration; Double-Blind Method; Energy metabolism; Fatigue; Humans; Insulin; Male; Medical examination; Metastases; Metastasis; Metastatic prostate cancer; Methods; Mortality; Muscle Strength; Muscles; Muscles - pathology; Musculoskeletal system; Neoplastic Processes; Oncology; Pharmacy; Physical training; Polyesters - pharmacology; Polyesters - therapeutic use; Prostate cancer; Prostatic Neoplasms - pathology; Quality of Life; Randomized Controlled Trials as Topic; Research design; Resistance Training; Strength training; Study Protocol; Supplements; Survival; Telehealth exercise; Telemedicine; Weight training
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-12260-3

Muscle mass is important for metastatic prostate cancer survival and quality of life (QoL). The backbone of treatment for men with metastatic castration sensitive prostate cancer (mCSPC) is androgen deprivation therapy (ADT) with an androgen signaling inhibitor. ADT is an effective cancer treatment, but it facilitates significant declines in muscle mass and adverse health outcomes important to mCSPC survivors, such as fatigue, and reductions in physical function, independence, insulin sensitivity, and QoL. In non-metastatic CSPC survivors, resistance training (RT) preserves muscle mass and improves these related health outcomes, but the biggest barrier to RT in CSPC survivors of all stages is fatigue. Creatine monohydrate supplementation coupled with RT (Cr + RT) may address this barrier since creatine plays a critical role in energy metabolism. Cr + RT in cancer-free older adults and other clinical populations improves muscle mass and related health outcomes. Evidence also suggests that creatine supplementation can complement cancer treatment. Thus, Cr + RT is a strategy that addresses gaps in survivorship needs of people with mCSPC. The purpose of this parallel, double-blind randomized controlled trial is to test the effects of 52-weeks of Cr + RT compared with placebo (PLA) and RT (PLA + RT) on muscle mass, other related health outcomes, and markers of cancer progression. We will carry out this trial with our team's established, effective, home-based, telehealth RT program in 200 mCSPC survivors receiving ADT, and evaluate outcomes at baseline, 24-, and 52-weeks. RT will occur twice weekly with elastic resistance bands, and an established creatine supplementation protocol will be used for supplementation delivery. Our approach addresses a major facilitator to RT in mCSPC survivors, a home-based RT program, while utilizing a supervised model for safety. Findings will improve delivery of comprehensive survivorship care by providing a multicomponent, patient-centered lifestyle strategy to preserve muscle mass, improve health outcomes, and complement cancer treatment (NCT06112990).