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.
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.
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 Four patients in the D + FO group were withdrawn from the trial because of adverse events related to the FO.
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.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2024 Dec 13 [Epub ahead of print]
William J Aronson, Tristan Grogan, Pei Liang, Patricia Jardack, Amana R Liddell, Claudia Perez, David Elashoff, Jonathan Said, Pinchas Cohen, Leonard S Marks, Susanne M Henning
Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA., Department of Medicine Statistics Core, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA., Clinical Translational Science Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA., Department of Pathology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA., Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA.