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2021 Emilio Bassini in Honor of Plum and Jonathan W. Simons, MD-PCF Young Investigator Award

Digital Activity Monitoring for Personalized Prediction of ADT-associated Fatigue

Andrew Laccetti, MD
Memorial Sloan Kettering Cancer Center

Mentors: Michael Morris, MD, Jessica Scott, PhD

Description:

  • Androgen deprivation therapy (ADT) and next-generation androgen receptor signaling inhibitors (ARSIs) are highly effective treatments for prostate cancer but are limited by side effects including fatigue. This fatigue can be severe, impacting function in up to 43% of men on long-term ADT. It represents one of the leading causes of treatment interruption or dose reduction for men on ARSIs and is associated with significantly impaired quality of life (QOL).
  • Predictors and modifiable risk factors for ADT-related fatigue remain to be established. Their discovery is critical to better guide treatment selection and identify patients best suited for preventative strategies.
  • Dr. Andrew Laccetti is studying the ability to use wearable activity monitors (WAMs) to study therapy-induced fatigue in prostate cancer patients. WAMs, like Fitbit or the Apple Watch, continuously record step count and physiological parameters like heart rate and sleep. They provide an objective measure of daily activity level in real-time.
  • In this project, Dr. Laccetti will conduct a prospective observational study in men with prostate cancer who are planned to initiate ADT alone or in combination with an ARSI (abiraterone, enzalutamide or apalutamide). Participants will be continuously monitored via a WAM to determine activity level (daily step count). Fatigue and quality of life questionnaires will be collected in addition to blood work. These measurements will be assessed for 12-months after starting treatment.
  • The relationships between pre-treatment activity level and changes in activity levels during treatment, and clinically meaningful fatigue after 12-months of ADT with/without an ARSI will be determined.
  • Whether inflammatory markers associate with clinically meaningful fatigue after 12-months of ADT with/without an ARSI will be investigated.
  • If successful, this project will establish real-time digital activity monitoring via a WAM as a means for clinicians to assess risk for the development of clinically meaningful ADT-related fatigue, which will better guide treatment selection. This work will also facilitate the identification of patients best suited to and support further research of mitigating strategies for treatment related fatigue</li

What this means to patients: Fatigue is a common and deleterious side effect of ADT and next-generation androgen receptor signaling inhibitors used for the treatment of prostate cancer. Dr. Laccetti will determine whether wearable activity monitors, like Fitbit or the Apple Watch, can be used to monitor patients for therapy-induced fatigue, and thus identify patients who require fatigue-mitigating strategies and interventions to improve their quality of life.