ClinicalTrials.gg
Status unknownNCT05367284TERESAUpdated May 10, 2022

Perioperative Testosterone Replacement Therapy in Sarcopenic Male Colorectal Cancer Patients

An observational study in Colorectal Cancer, Sarcopenia and Hypogonadism, Male, sponsored by London North West Healthcare NHS Trust. Status unknown at 1 site in United Kingdom. Open to male participants aged 45 Years and older. Per ClinicalTrials.gov, last updated 2022-05-10.

Sponsored by London North West Healthcare NHS Trust · Observational

The sponsor has not verified this record recently (last verified Oct 2021), so the status shown — last known as Recruiting — may be out of date.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
30
Ages
45 Years and older
Sex
Male
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Study summary

With increasing age and the additional impact from the bowel cancer and the chemotherapy and/ or radiotherapy it has been described that testosterone (a male hormone produced naturally in the body) levels are reduced. Testosterone has an impact on numerous body functions including the muscle mass and quality. Previous studies have identified that muscle mass is reduced as a result of ageing but also because of the deleterious effect of cancer and chemotherapy and/or radiotherapy. There is growing evidence from published studies that patients with better muscle mass and quality, do better after surgery. Mr Jenkins and his team are therefore looking at ways, the investigators can try and prevent or reduce this muscle loss and therefore improve patient outcomes.

The aim of this study is to assess whether using testosterone replacement therapy in the form of a topically applied gel daily for a total of 12 weeks, is feasible and acceptable by the patients who are diagnosed with colorectal cancer and are waiting to undergo surgery. The investigators will also collect information related to the testosterone replacement therapy such as questionnaires on the quality of life, fatigue and muscle mass, and blood biomarker changes in the blood.

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Conditions studied

  • Colorectal Cancer
  • Sarcopenia
  • Hypogonadism, Male
  • Perioperative Care
  • Testosterone Replacement Therapy
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In context

Colorectal Neoplasms

6,541 studies on the registry are indexed under Colorectal Neoplasms; 1,667 are open to participants now.

This study's planned enrollment of 30 is below the median of 250 across 1,440 observational studies indexed under Colorectal Neoplasms.

Browse Colorectal Neoplasms studies →

Lead sponsor

London North West Healthcare NHS Trust is the lead sponsor of 55 studies on the registry; 11 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
45 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients diagnosed with colorectal cancer who attend to the surgical clinic, following completion of their neoadjuvant chemoradiotherapy or for initial review by the surgical team in order to proceed with surgery.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male ≥ 45 years old
  • Colorectal cancer - histology confirmed
  • Identified as sarcopenic on latest computerised tomography (CT) scan prior to intervention (part of initial investigations - using Martin et al (2013) criteria - 43cm2/m2 for (BMI) \<25, 53cm2/m2 for BMI>25)
  • Documented low or normal testosterone at time of recruitment (\<12 nano moles/ Litre (nmol/L)
  • Eligible for operative intervention
  • Capacity to consent
  • Able to mobilise \& able to complete the 6 Minute Walk Test (MWT)
  • Post completion of chemotherapy/ chemoradiotherapy treatment (if the patient has treatment)
  • Booked straight for surgery with an interim of 4-8 weeks.
  • Participation in another concurrent trial/ study is accepted, following discussion between the two trial /study teams

Exclusion criteria

Exclusion Criteria:

  • Not sarcopenic on computerised tomography (CT)
  • Not eligible for surgery
  • History of Deep Vein Thrombosis (DVT)/ Pulmonary Embolism (PE)/ prostate cancer/ breast cancer
  • Prostate nodule identified during digital rectal examination (DRE) or magnetic resonance imaging (MRI) pelvis
  • Multiple distant which are non-operable
  • Prostate specific antigen (PSA) > 3 nanogram/ mililitre (ng/ml)
  • Haematocrit (HCT) >52%
  • Severe lower urinary tract symptoms
  • Class III/ IV heart failure
  • Myocardial Infarct or stroke within the last 6 months
  • Dementia / No capacity to consent
  • Patient on medications with anti-androgen effect eg spironolactone
  • Patients with untreated severe obstructive sleep apnoea
  • Morbid obesity as defined by (BMI) >40
  • Uncontrolled hypertension
  • Patients on long term during the trial period
  • Patient on other anabolic agents
  • Not already on treatment for primary hypogonadism
  • Patients with bone metastasis
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
30 participants (estimated)
Patient registry
No

Interventions

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What researchers measure

Primary outcomes

  1. Number of days required for a patient to be recruited on the study and how many patients are recruited

    number of days required for patients to be recruited and number of patients recruited by the closure of the study

    Time frame: 1 year

  2. Number of patients who will complete the 12 week treatment

    retention of the patients for a the total of 12 weeks by the time of recruitment, will be measured in days on study

    Time frame: 12 weeks

  3. Treatment acceptability questionnaire

    questionnaire on the difficulty experience (Likert scale) for the use of the gel for 12 weeks, if they developed any side effects as described on the CTCAE version 5.0

    Time frame: 12 weeks

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Study locations

1 of 1 sites recruiting
  • London North West University Healthcare NHS Trust
    London, United Kingdom
    Recruiting
    • I Drami, MSc, MRCS · Contact
    • I Drami, MSc, MRCS · Principal investigator
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References and documents

Publications

  • Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab. 2008 Oct;33(5):997-1006. doi: 10.1139/H08-075. PubMed 18923576 ↗
  • Mullie L, Afilalo J. CoreSlicer: a web toolkit for analytic morphomics. BMC Med Imaging. 2019 Feb 11;19(1):15. doi: 10.1186/s12880-019-0316-6. PubMed 30744586 ↗
  • Bozzetti F. Forcing the vicious circle: sarcopenia increases toxicity, decreases response to chemotherapy and worsens with chemotherapy. Ann Oncol. 2017 Sep 1;28(9):2107-2118. doi: 10.1093/annonc/mdx271. PubMed 28911059 ↗
  • Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31. doi: 10.1093/ageing/afy169. Erratum In: Age Ageing. 2019 Jul 1;48(4):601. doi: 10.1093/ageing/afz046. PubMed 30312372 ↗
  • Trejo-Avila M, Bozada-Gutierrez K, Valenzuela-Salazar C, Herrera-Esquivel J, Moreno-Portillo M. Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis. 2021 Jun;36(6):1077-1096. doi: 10.1007/s00384-021-03839-4. Epub 2021 Jan 22. PubMed 33481108 ↗
  • Lee CM, Kang J. Prognostic impact of myosteatosis in patients with colorectal cancer: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2020 Oct;11(5):1270-1282. doi: 10.1002/jcsm.12575. Epub 2020 Jun 1. PubMed 32483936 ↗
  • Pring ET, Malietzis G, Kennedy RH, Athanasiou T, Jenkins JT. Cancer cachexia and myopenia - Update on management strategies and the direction of future research for optimizing body composition in cancer - A narrative review. Cancer Treat Rev. 2018 Nov;70:245-254. doi: 10.1016/j.ctrv.2018.10.002. Epub 2018 Oct 6. PubMed 30321741 ↗
  • Herbst KL, Bhasin S. Testosterone action on skeletal muscle. Curr Opin Clin Nutr Metab Care. 2004 May;7(3):271-7. doi: 10.1097/00075197-200405000-00006. PubMed 15075918 ↗
  • Burney BO, Garcia JM. Hypogonadism in male cancer patients. J Cachexia Sarcopenia Muscle. 2012 Sep;3(3):149-55. doi: 10.1007/s13539-012-0065-7. Epub 2012 Apr 20. PubMed 22528986 ↗
  • Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR; Baltimore Longitudinal Study of Aging. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001 Feb;86(2):724-31. doi: 10.1210/jcem.86.2.7219. PubMed 11158037 ↗
  • Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD, Bremner WJ, McKinlay JB. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab. 2002 Feb;87(2):589-98. doi: 10.1210/jcem.87.2.8201. PubMed 11836290 ↗
  • Slattery ML, Sweeney C, Murtaugh M, Ma KN, Wolff RK, Potter JD, Caan BJ, Samowitz W. Associations between ERalpha, ERbeta, and AR genotypes and colon and rectal cancer. Cancer Epidemiol Biomarkers Prev. 2005 Dec;14(12):2936-42. doi: 10.1158/1055-9965.EPI-05-0514. PubMed 16365013 ↗
  • Lu Y, Ljung R, Martling A, Lindblad M. Risk of Colorectal Cancer by Subsite in a Swedish Prostate Cancer Cohort. Cancer Control. 2015 Apr;22(2):263-70. doi: 10.1177/107327481502200222. PubMed 26068776 ↗
  • Gillessen S, Templeton A, Marra G, Kuo YF, Valtorta E, Shahinian VB. Risk of colorectal cancer in men on long-term androgen deprivation therapy for prostate cancer. J Natl Cancer Inst. 2010 Dec 1;102(23):1760-70. doi: 10.1093/jnci/djq419. Epub 2010 Nov 10. PubMed 21068432 ↗
  • Sah BK, Chen MM, Peng YB, Feng XJ, Yan M, Liu BY, Fan QS, Zhu ZG. Does testosterone prevent early postoperative complications after gastrointestinal surgery? World J Gastroenterol. 2009 Nov 28;15(44):5604-9. doi: 10.3748/wjg.15.5604. PubMed 19938202 ↗
  • Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, Bunnell TJ, Tricker R, Shirazi A, Casaburi R. The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. N Engl J Med. 1996 Jul 4;335(1):1-7. doi: 10.1056/NEJM199607043350101. PubMed 8637535 ↗
  • Wright TJ, Dillon EL, Durham WJ, Chamberlain A, Randolph KM, Danesi C, Horstman AM, Gilkison CR, Willis M, Richardson G, Hatch SS, Jupiter DC, McCammon S, Urban RJ, Sheffield-Moore M. A randomized trial of adjunct testosterone for cancer-related muscle loss in men and women. J Cachexia Sarcopenia Muscle. 2018 Jun;9(3):482-496. doi: 10.1002/jcsm.12295. Epub 2018 Apr 14. PubMed 29654645 ↗
  • Walsh JS, Marshall H, Smith IL, Greenfield DM, Swain J, Best E, Ashton J, Brown JM, Huddart R, Coleman RE, Snowden JA, Ross RJ. Testosterone replacement in young male cancer survivors: A 6-month double-blind randomised placebo-controlled trial. PLoS Med. 2019 Nov 12;16(11):e1002960. doi: 10.1371/journal.pmed.1002960. eCollection 2019 Nov. PubMed 31714912 ↗
  • Wynter-Blyth V, Moorthy K. Prehabilitation: preparing patients for surgery. BMJ. 2017 Aug 8;358:j3702. doi: 10.1136/bmj.j3702. No abstract available. PubMed 28790033 ↗
  • Santa Mina D, van Rooijen SJ, Minnella EM, Alibhai SMH, Brahmbhatt P, Dalton SO, Gillis C, Grocott MPW, Howell D, Randall IM, Sabiston CM, Silver JK, Slooter G, West M, Jack S, Carli F. Multiphasic Prehabilitation Across the Cancer Continuum: A Narrative Review and Conceptual Framework. Front Oncol. 2021 Jan 11;10:598425. doi: 10.3389/fonc.2020.598425. eCollection 2020. PubMed 33505914 ↗
  • Jang MK, Park C, Hong S, Li H, Rhee E, Doorenbos AZ. Skeletal Muscle Mass Change During Chemotherapy: A Systematic Review and Meta-analysis. Anticancer Res. 2020 May;40(5):2409-2418. doi: 10.21873/anticanres.14210. PubMed 32366384 ↗
  • Blauwhoff-Buskermolen S, Versteeg KS, de van der Schueren MA, den Braver NR, Berkhof J, Langius JA, Verheul HM. Loss of Muscle Mass During Chemotherapy Is Predictive for Poor Survival of Patients With Metastatic Colorectal Cancer. J Clin Oncol. 2016 Apr 20;34(12):1339-44. doi: 10.1200/JCO.2015.63.6043. Epub 2016 Feb 22. PubMed 26903572 ↗
  • Dobs AS, Boccia RV, Croot CC, Gabrail NY, Dalton JT, Hancock ML, Johnston MA, Steiner MS. Effects of enobosarm on muscle wasting and physical function in patients with cancer: a double-blind, randomised controlled phase 2 trial. Lancet Oncol. 2013 Apr;14(4):335-45. doi: 10.1016/S1470-2045(13)70055-X. Epub 2013 Mar 14. PubMed 23499390 ↗
  • Wu B, Lorezanza D, Badash I, Berger M, Lane C, Sum JC, Hatch GF 3rd, Schroeder ET. Perioperative Testosterone Supplementation Increases Lean Mass in Healthy Men Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. Orthop J Sports Med. 2017 Aug 9;5(8):2325967117722794. doi: 10.1177/2325967117722794. eCollection 2017 Aug. PubMed 28840147 ↗
  • Shafqat A, Einhorn LH, Hanna N, Sledge GW, Hanna A, Juliar BE, Monahan P, Bhatia S. Screening studies for fatigue and laboratory correlates in cancer patients undergoing treatment. Ann Oncol. 2005 Sep;16(9):1545-50. doi: 10.1093/annonc/mdi267. Epub 2005 May 26. PubMed 15919683 ↗
  • Del Fabbro E, Garcia JM, Dev R, Hui D, Williams J, Engineer D, Palmer JL, Schover L, Bruera E. Testosterone replacement for fatigue in hypogonadal ambulatory males with advanced cancer: a preliminary double-blind placebo-controlled trial. Support Care Cancer. 2013 Sep;21(9):2599-607. doi: 10.1007/s00520-013-1832-5. Epub 2013 May 8. PubMed 23653013 ↗
  • Wischmeyer PE, Suman OE, Kozar R, Wolf SE, Molinger J, Pastva AM. Role of anabolic testosterone agents and structured exercise to promote recovery in ICU survivors. Curr Opin Crit Care. 2020 Oct;26(5):508-515. doi: 10.1097/MCC.0000000000000757. PubMed 32773614 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 10, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05367284
Lead sponsor
London North West Healthcare NHS Trust
Responsible party
Sponsor
First posted
May 10, 2022
Start date
Jan 15, 2022
Primary completion
Mar 2023 (estimated)
Completion
Mar 2023 (estimated)
Last update
May 10, 2022

Study contacts

Ioanna Drami, MSc, MRCS
Contact
i.drami20@imperial.ac.uk
+4420 8864 3232
JT Jenkins, MD, FRCS
principal investigator · London North West University Hospital Healthcare NHS Trust

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Oct 2021. You cannot join it, but the record below documents what was studied.

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