Testosterone Replacement for Low Testosterone in Prostate Cancer on Active Surveillance

This study is looking at how testosterone replacement therapy (TRT) affects men with localized prostate cancer (cancer that hasn't spread) who are on active surveillance (AS). AS means closely watching the cancer without immediate treatment. The study is for men who have low testosterone (hypogonadal men), which can cause symptoms like low sex drive. Researchers want to see if TRT impacts how the cancer changes over time (Gleason grade progression) and if it affects when men might need to stop AS. They will also look at how TRT affects your quality of life, including urinary symptoms and sexual health. About 600 men will participate in this study.

Study design
This interventional study plans to enroll 600 men. Participants will be assigned to one of three groups, with one group receiving standard active surveillance.
What's involved
You may undergo a prostate biopsy, blood sample collection, MRI scans, and complete questionnaires. Your participation could last up to 5 years.
Compensation
Not stated in the trial record.
Follow-up
The study will follow participants for up to 5 years to assess various outcomes.

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NCT06733350

Testosterone Replacement Therapy for the Treatment of Low Testosterone in Hypogonadal Men With Localized Prostate Cancer on Active Surveillance

Recruiting
PHASE4Ages 18+InterventionalTreatment
Roswell Park Cancer Institute
~600 participants
Updated 2026-05-14 on ClinicalTrials.gov
What's tested:Biopsy of ProstateBiospecimen CollectionMagnetic Resonance ImagingPatient ObservationQuestionnaire AdministrationTherapeutic Testosterone

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Gleason grade progression
Measured over From start of active surveillance until any progression in primary, secondary, or a combination of Gleason grades, definitive treatment, or last follow-up, assessed up to 5 years
+3 more outcomes measured
Localized Prostate Carcinoma
Stage I Prostate Cancer AJCC v8
Stage II Prostate Cancer AJCC v8
Stage III Prostate Cancer AJCC v8
1 sites across 1 states
New York1
  • Ahmed Aly · PRINCIPAL_INVESTIGATOR · Roswell Park Cancer Institute

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Eligibility criteria

Inclusion

Men aged ≥ 18 years
Men with localized prostate cancer are eligible for active surveillance (National Comprehensive Cancer Network \[NCCN\] very low, low, and intermediate favorable risk group)
Participant must understand the investigational nature of this study and sign an independent ethics committee/institutional review board approved written informed consent form prior to receiving any study related procedure

Exclusion

Patients with NCCN intermediate unfavorable, high risk, or very high-risk localized prostate cancer
For men being considered for Group 2 (TRT), Patients with contraindications to TRT, which include,
Locally advanced or metastatic prostate cancer
Male breast cancer
Men with an active desire to have children
Hematocrit levels \> 54% or baseline hematocrit of 48-50%
Uncontrolled or poorly controlled congestive heart failure
IPSS (International Prostate Symptom Score) score \> 19
Family history of venous thromboembolism
Unwilling or unable to follow protocol requirements
Any condition which in the investigator's opinion deems the participant an unsuitable candidate to participate in the study
  • Gleason grade progressionFrom start of active surveillance until any progression in primary, secondary, or a combination of Gleason grades, definitive treatment, or last follow-up, assessed up to 5 years

    The Gleason grade progression will be summarized by group using standard Kaplan-Meier methods, where estimates of the median or specified rates will be obtained. Comparisons will be made between groups using the log-rank test. As exploratory analyses, Cox regression models may be considered to adjust for relevant demographic or clinical confounders. The Bonferroni method will be used to control the family-wise error rate at 0.10.

  • Discontinuation of active surveillanceFrom start of active surveillance until discontinuation of active surveillance due to any cause or last follow-up, assessed up to 5 years

    The discontinuation of active surveillance will be summarized by group using standard Kaplan-Meier methods, where estimates of the median or specified rates will be obtained. Comparisons will be made between groups using the log-rank test. As exploratory analyses, Cox regression models may be considered to adjust for relevant demographic or clinical confounders. The Bonferroni method will be used to control the family-wise error rate at 0.10.

  • International Prostate Symptom Score (Quality-of-life)Up to 5 years

    Will be modeled as a function of group, timepoint, their two-way interaction, and a random subject effect using linear mixed models. Tests about the appropriate contrasts of model estimates will be used to compare mean changes in quality of life between groups at specified timepoints. All model assumptions will be verified graphically, and transformations applied as appropriate. As exploratory analyses, additional models may be considered to adjust for relevant demographic or clinical confounders. The Bonferroni method will be used to control the family-wise error rate at 0.10.

  • Sexual Health Inventory for Men score (Quality-of-life)Up to 5 years

    Will be modeled as a function of group, timepoint, their two-way interaction, and a random subject effect using linear mixed models. Tests about the appropriate contrasts of model estimates will be used to compare mean changes in quality of life between groups at specified timepoints. All model assumptions will be verified graphically, and transformations applied as appropriate. As exploratory analyses, additional models may be considered to adjust for relevant demographic or clinical confounders. The Bonferroni method will be used to control the family-wise error rate at 0.10.