Pentoxifylline, Atorvastatin, and Vitamin E in Treating Patients With Erectile Dysfunction After Radiation Therapy for Prostate Cancer

Inclusion Criteria:

Histologically or cytologically confirmed diagnosis of adenocarcinoma of the prostate
Previous radiation therapy (any form) with curative intent for prostate cancer
Erectile dysfunction, as determined by an International Index of Erectile Function (IIEF)-5 score of < 22
Normal testosterone (including men on testosterone replacement), defined as testosterone > 150 ng/dl at the time of screening
Karnofsky Performance Status (KPS) >= 70, or Eastern Cooperative Oncology Group (ECOG) 0-2
Patients may be taking an HMG-coA-reductase inhibitor
Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< 3 X upper limits of normal (ULN)
Creatinine kinase < 5 times ULN
Normal renal function is defined as creatinine clearance >= 30 ml/min via the Cockcroft Gault formula

Exclusion Criteria:

No androgen deprivation therapy within the past 12 months
No contraindication to an HMG-coA-reductase inhibitor, vitamin E or pentoxifylline
Not currently taking cyclosporine, the human immunodeficiency virus (HIV) protease inhibitors, hepatitis C protease inhibitors, gemfibrozil, other fibrates, clarithromycin, itraconazole or strong inhibitors of CYP3A4
No recent cerebral or retinal hemorrhage that in the opinion of the treating physician would make PAVE unsafe (within 6 months)
No current chemotherapy during study participation
No active liver or muscle disease that in the opinion of the treating physician would make PAVE unsafe
No prior radical prostatectomy, cystoprostatectomy, abdominoperineal resection or retroperitoneal lymph node dissection
Not currently taking a 5PDE inhibitor nor have used one within 30 days of enrolling in the study
No recent deep venous thrombosis, myocardial infarction or pulmonary embolism (within 6 months) requiring continued anticoagulation other than aspirin (acetylsalicylic acid [ASA])
No cardiac arrhythmias or artificial heart valves requiring anticoagulation other than ASA
No concurrent drugs with anti-platelet therapy properties (e.g., P2Y12 inhibitors, non-steroidal anti-inflammatory agents, selective serotonin reuptake inhibitors) other than low dose ASA (81 mg/d)
Not currently taking high dose statin therapy, defined as rosuvastatin > 10 mg/d or atorvastatin > 40 mg/d
Not currently taking theophylline
No history of active peptic ulcer disease in the past 6 months
No history of intolerance to pentoxifylline or methylxanthines such as caffeine, theophylline and theobromine that in the opinion of the treating physician would make PAVE unsafe
No concurrent use of CYP1A2 inhibitors (e.g., ciprofloxacin), ketorolac, or vitamin K antagonists (e.g. warfarin)