PMID- 36544211 OWN - NLM STAT- MEDLINE DCOM- 20221223 LR - 20230314 IS - 1745-6215 (Electronic) IS - 1745-6215 (Linking) VI - 23 IP - 1 DP - 2022 Dec 21 TI - The effect of a phytoestrogen intervention and impact of genetic factors on tumor proliferation markers among Swedish patients with prostate cancer: study protocol for the randomized controlled PRODICA trial. PG - 1041 LID - 10.1186/s13063-022-06995-2 [doi] LID - 1041 AB - BACKGROUND: A high intake of phytoestrogens, found in soy, rye, and seeds, is associated with a reduced risk of a prostate cancer diagnosis. Previously, we found that the overall decreased risk of prostate cancer diagnosis in males with a high intake of phytoestrogens was strongly modified by a nucleotide sequence variant in the estrogen receptor-beta (ERbeta) gene. However, we do not know if phytoestrogens can inhibit the growth of prostate cancer in males with established diseases. If there is an inhibition or a delay, there is reason to believe that different variants of the ERbeta gene will modify the effect. Therefore, we designed an intervention study to investigate the effect of the addition of foods high in phytoestrogens and their interaction with the ERbeta genotype on prostate tumor proliferation in patients with prostate cancer. METHOD: The PRODICA trial is a randomized ongoing intervention study in patients with low- and intermediate-risk prostate cancer with a Gleason score < 8, prostate-specific antigen (PSA) < 20, and scheduled for radical prostatectomy. The study is conducted at Sahlgrenska University Hospital in Gothenburg, Sweden. The intervention consists of a daily intake of soybeans and flaxseeds (~ 200 mg of phytoestrogens) until the surgery, approximately 6 weeks. The aim is to recruit 200 participants. The primary outcome is the difference in the proliferation marker Ki-67 between the intervention and the control groups. The genotype of ERbeta will be investigated as an effect-modifying factor. Secondary outcomes include, e.g., concentrations of PSA and steroid hormones in the blood. DISCUSSION: The results of the PRODICA trial will contribute important information on the relevance of increasing the intake of phytoestrogens in patients with prostate cancer who want to make dietary changes to improve the prognosis of their cancer. If genetic factors turn out to influence the effect of the intervention diet, dietary advice can be given to patients who most likely benefit from it. Dietary interventions are cost-effective, non-invasive, and result in few mild side effects. Lastly, the project will provide basic pathophysiological insights which could be relevant to the development of treatment strategies for patients with prostate cancer. CLINICALTRIALS: gov NCT02759380. Registered on 3 May 2016. CI - (c) 2022. The Author(s). FAU - Ahlin, Rebecca AU - Ahlin R AD - Department of Oncology, Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Box 423, 40530, Gothenburg, Sweden. FAU - Nybacka, Sanna AU - Nybacka S AD - Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. FAU - Josefsson, Andreas AU - Josefsson A AD - Department of Urology, Sahlgrenska Cancer Center, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. AD - Wallenberg Center for Molecular Medicine, Umea University, Umea, Sweden. AD - Department of Urology and Andrology, Institute of Surgery and Perioperative Sciences, Umea University, Umea, Sweden. FAU - Stranne, Johan AU - Stranne J AD - Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. AD - Department of Urology, Sahlgrenska University Hospital, Region Vastra Gotaland, Gothenburg, Sweden. FAU - Steineck, Gunnar AU - Steineck G AD - Department of Oncology, Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Box 423, 40530, Gothenburg, Sweden. FAU - Hedelin, Maria AU - Hedelin M AUID- ORCID: 0000-0002-8917-2495 AD - Department of Oncology, Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Box 423, 40530, Gothenburg, Sweden. maria.hedelin@oncology.gu.se. AD - Regional Cancer Center West, Sahlgrenska University Hospital, Region Vastra Gotaland, Gothenburg, Sweden. maria.hedelin@oncology.gu.se. LA - eng SI - ClinicalTrials.gov/NCT02759380 GR - 2021:353/Stiftelsen Jubileumsklinikens Forskningsfond mot Cancer/ GR - 2020:320/Stiftelsen Jubileumsklinikens Forskningsfond mot Cancer/ GR - 2019:262/Stiftelsen Jubileumsklinikens Forskningsfond mot Cancer/ GR - 2018:206/Stiftelsen Jubileumsklinikens Forskningsfond mot Cancer/ GR - 2017:145/Stiftelsen Jubileumsklinikens Forskningsfond mot Cancer/ GR - 2016:76/Stiftelsen Jubileumsklinikens Forskningsfond mot Cancer/ GR - Maria Hedelin 2014/Dr.P.Hakansson's Foundation/ GR - 2013/Lions Cancerfond Vast/ GR - 10/Lions Cancerfond Vast/ GR - ProLiv Vast/ GR - ALFGBG-727821/LUA/ALF agreement in West of Sweden health care region/ GR - ALFGBG-966360/LUA/ALF agreement in West of Sweden health care region/ GR - KAW 2015.0114/Knut och Alice Wallenbergs Stiftelse/ PT - Clinical Trial Protocol PT - Journal Article DEP - 20221221 PL - England TA - Trials JT - Trials JID - 101263253 RN - 0 (Phytoestrogens) RN - EC 3.4.21.77 (Prostate-Specific Antigen) RN - 0 (Biomarkers, Tumor) RN - 0 (Estrogen Receptor beta) SB - IM EIN - Trials. 2023 Mar 13;24(1):187. PMID: 36915190 MH - Male MH - Humans MH - *Phytoestrogens/adverse effects MH - Prostate-Specific Antigen MH - Biomarkers, Tumor/genetics MH - Sweden MH - Estrogen Receptor beta/genetics MH - *Prostatic Neoplasms/drug therapy/genetics/surgery MH - Cell Proliferation MH - Randomized Controlled Trials as Topic PMC - PMC9768998 OTO - NOTNLM OT - Food frequency questionnaire OT - Gene-diet interaction OT - Phytoestrogens OT - Prostate cancer COIS- The authors declare that they have no competing interests. EDAT- 2022/12/22 06:00 MHDA- 2022/12/24 06:00 PMCR- 2022/12/21 CRDT- 2022/12/21 23:50 PHST- 2022/08/31 00:00 [received] PHST- 2022/12/08 00:00 [accepted] PHST- 2022/12/21 23:50 [entrez] PHST- 2022/12/22 06:00 [pubmed] PHST- 2022/12/24 06:00 [medline] PHST- 2022/12/21 00:00 [pmc-release] AID - 10.1186/s13063-022-06995-2 [pii] AID - 6995 [pii] AID - 10.1186/s13063-022-06995-2 [doi] PST - epublish SO - Trials. 2022 Dec 21;23(1):1041. doi: 10.1186/s13063-022-06995-2.