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High Omega-3, Low Omega-6 Fatty Acid Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance
TAKE-HOME MESSAGE
- This phase II randomized trial evaluated the effects of a high omega-3, low omega-6 fatty acid diet with fish oil (D + FO) on prostate cancer progression in men undergoing active surveillance for grade group 1 or 2 prostate cancer. A total of 100 men were randomized to either the D + FO intervention or a control diet, with same-site prostate biopsies taken at baseline and after 1 year. The primary endpoint was the change in the Ki-67 index, a biomarker for cancer proliferation, metastasis, and mortality. After 1 year, the D + FO group experienced an approximately 15% decrease in the Ki-67 index (from 1.34% to 1.14%), whereas the control group experienced an approximately 24% increase (from 1.23% to 1.52%), resulting in a statistically significant difference in the change between the groups (P = .043). However, secondary outcomes, including the grade group, tumor length, Decipher genomic score, and prostate-specific antigen, did not differ between the groups. Adverse events related to fish oil led to the withdrawal of 4 patients in the D + FO group.
- These findings suggest that a D + FO dietary intervention reduces tumor proliferation, supporting further phase III trials to evaluate this intervention in men on active surveillance.
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
Men on active surveillance (AS) for prostate cancer are extremely interested in dietary changes or supplements to prevent progression of their disease. We sought to determine whether a high omega-3, low omega-6 fatty acid diet with fish oil capsules (D + FO) decreases proliferation (Ki-67) in prostate biopsies in men with prostate cancer on AS over a 1-year time period.
METHODS
In this phase II, prospective randomized trial, men (N = 100) with grade group 1 or 2 prostate cancer who elected AS were randomly assigned to the D + FO or a control group. Same-site prostate biopsies were obtained at baseline and 1 year. The primary end point was the change in Ki-67 index from baseline to 1 year from same-site biopsies compared between the groups.
RESULTS
The Ki-67 index decreased in the D + FO group by approximately 15% from baseline to 1 year (1.34% at baseline, 1.14% at 1 year) and increased in the control group by approximately 24% from baseline to 1 year (1.23% at baseline, 1.52% at 1 year), resulting in a statistically significant difference in the change of Ki-67 index between the groups (95% CI, 2% to 52%, P = .043). There was no significant difference in the secondary outcomes grade group, tumor length, Decipher genomic score, or prostate-specific antigen between the two groups. Four patients in the D + FO group were withdrawn from the trial because of adverse events related to the FO.
CONCLUSION
A high omega-3, low omega-6 diet with FO for 1 year resulted in a significant reduction in Ki-67 index, a biomarker for prostate cancer progression, metastasis, and death. These findings support future phase III trials incorporating this intervention in men on AS.
Additional Info
High Omega-3, Low Omega-6 Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial
J. Clin. Oncol 2024 Dec 13;[EPub Ahead of Print], WJ Aronson, T Grogan, P Liang, P Jardack, AR Liddell, C Perez, D Elashoff, J Said, P Cohen, LS Marks, SM HenningFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.