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Metabolic SyndromeACTNCT01642680

Optimal Timing of Physical Activity in Cancer Treatment

A study testing A tailored physical activity program during chemotherapy and A tailored physical activity program after chemotherapy in people with Metabolic Syndrome and Vascular Disorders, run by University Medical Center Groningen at 1 site in Netherlands.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The number of long-term cancer survivors is growing. As a result, treatment-related morbidity - such as cardiovascular disease, metabolic syndrome, functional decline and fatigue - is impacting quality of life and impairing survival. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
A tailored physical activity program during chemotherapy and A tailored physical activity program after chemotherapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
266 participants
Where
1 siteNetherlands
Study dates
24 Jan 2013to 22 Oct 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with testicular, early colon, breast cancer or B-NHL with an indication for systemic chemotherapy with a curative intent
  • Normal blood count at start of systemic treatment
  • Patients need to have an adequate physical health, which is defined by diastolic blood pressure >45 mm Hg or <95 mm Hg; heart frequency in at rest < 100 per minute; body temperature below 38°C; respiration frequency in rest below 20 per minute
  • Adequate cardiac function with a LVEF above the lower limit of normal
  • Written informed consent

Who cannot join

  • Infections requiring actual antibiotics
  • Signs of ongoing bleeding or fresh petechiae; unexplained bruises
  • Critical organ impairment due to their malignancy
  • Not recovered from earlier surgical intervention
  • Non adequate control of any symptoms of the malignancy
  • Inability to travel independently to the rehabilitation centre
  • Cognitive disorder or emotional instability that might impede the participation in the training program
  • Recent cardiovascular event

Trial locations and contacts

1 site in 1 country.

Netherlands1 site
  • University Medical Centre Groningen

    Groningen, 9713GZ

Other trials in Netherlands

About this study

Official title: Optimal Timing of a Tailored Physical Activity Program During Chemotherapeutic Cancer Treatment to Reduce Long-term Cardiovascular Morbidity

The number of long-term cancer survivors is growing. As a result, treatment-related morbidity - such as cardiovascular disease, metabolic syndrome, functional decline and fatigue - is impacting quality of life and impairing survival. Metabolic syndrome in the general population is currently treated with lifestyle advice to increase physical activity (PA) and reduce caloric intake. This approach is still underused as standard care for cancer survivors. The aim of this study is investigate whether a tailored PA program that starts early (during curative chemotherapy with cardiovascular toxic potential) is superior in terms of reducing long-term cancer-treatment-related metabolic syndrome and cardiovascular morbidity to a program that starts late (after completion of chemotherapy).

Read the detailed description

Improved treatment is partly responsible for the increased survival and life expectancy in cancer patients. However, such treatment can be harmful as well, and cancer survivors therefore, face an increased risk of second malignancies and other chronic diseases, e.g. cardiovascular diseases and metabolic syndrome.

Due to the growing number of cancer patients and survivors, attention for rehabilitation, especially physical training, is growing. Several meta-analyses show the beneficial effects of physical training on several outcomes such as physical fitness, muscle strength, fatigue and quality of life, and a few studies showed the effect of exercise on physical active behaviour. However, studies on the effect of timing of exercise are lacking.

The present study aims to insert a tailored physical activity program early versus late in the chemotherapy based cancer treatment and will yield data about its safety and efficacy. We hypothesize that a tailored physical activity program during early cancer treatment may more be effective to reduce long-term cancer treatment toxicities and morbidity in cancer survivors compared to a program after cancer treatment.

Primary Objective: To investigate whether a tailored physical activity program that starts during chemotherapy (early) is superior in terms of physical fitness, as determined by VO2 peak at one year, to a program that starts after completion of chemotherapy (late).

Secondary Objectives: To examine the effect of the physical activity program on muscle strength and activity level, change in metabolic and cardiovascular damage parameters, cardiovascular risk factors and quality of life including self-efficacy, motivation for exercise, and fatigue.

Design: This protocol describes a multicenter, randomized study with 2 arms. Patients who will be treated with curative systemic chemotherapeutic treatment for testicular cancer, early colon cancer, early breast cancer or B-NHL will be randomized into an early or late PA program group. The early group will start the PA program during chemotherapy (for 12 weeks) until 12 weeks after completion of chemotherapy (total 24 weeks of training). The late group will start the same program (total of 12 weeks) after completion of chemotherapy. The longitudinal effects of the physical activity (PA) program for all participants will be evaluated at different time points in the UMCG: before start of chemotherapeutic treatment; at the start of the PA program and at 3, 6, 18 months after starting the PA program and 18 months after the last chemotherapy.

Being tested
A tailored physical activity program during chemotherapy, A tailored physical activity program after chemotherapy
Keywords
Physical activity program, Chemotherapy, Metabolic syndrome, Reducing cardiovascular risk factors, low physical activity level
Medical subject headings
Metabolic Syndrome, Vascular Diseases, Fatigue

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • A tailored physical activity program during chemotherapyOther

    The early group will start the PA program during chemotherapy for 3 months, and after completion of chemotherapy for 3 months (total 6 months). The PA program will consist of two components: improvement of physical fitness and empowerment to adopt a healthy lifestyle. Longitudinal effects of this PA program will be evaluated at 5 time points: before chemotherapy; at start of the PA program and at 3, 6 and 18 months after start of the PA program. Safety parameters will be monitored throughout the study period.

  • A tailored physical activity program after chemotherapyOther

    The late group will start the PA program after completion of the chemotherapy for 6 months. The PA program will consist of two components: improvement of physical fitness and empowerment to adopt a healthy lifestyle. Longitudinal effects of this PA program will be evaluated at 5 time points: before chemotherapy; at start of the PA program and at 3, 6 and 18 months after start of the PA program. Safety parameters will be monitored throughout the study period.

Study groups in NCT01642680
Study groupRoleWhat they receive
Physical activity during chemotherapyExperimentalThis group will start with a physical activity program 3 months before the end of their chemotherapeutic regimen. After chemotherapy they will continue the PA program for another 3 months.
Receives: Other: A tailored physical activity program during chemotherapy
Physical activity after chemotherapyActive comparatorThis group will start with a physical activity program after the end of their chemotherapeutic regimen. The physical activity program wil take 6 months to complete.
Receives: Other: A tailored physical activity program after chemotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Difference in VO2 peak between the groups after completion of the PA program, measured by cardiopulmonary exercise testing (CPET).

    The aim of this study is investigate whether a tailored PA program that starts early (during curative chemotherapy with cardiovascular toxic potential) is superior in terms of reducing long-term cancer-treatment-related metabolic syndrome and cardiovascular morbidity to a program that starts late (after completion of chemotherapy).

    The VO2 at the peak of the exercise will be defined as peak oxygen uptake (VO2 peak), measured by cardiopulmonary exercise testing (CPET) on a stationary bicycle ergometer. The CPET is considered to be the most precise measure of cardio-respiratory fitness and is recommended for use in order to determine a patient's objective or subjective difference in exercise capacity

    Measured: 1,5 year

Secondary outcomes (26)
  1. Muscle strength using a hand-held dynamometer

    Maximal voluntary isometric muscle force of the right and left extremity of extension of the knee, flexion of the knee, flexion of the elbow and extension of the elbow will be measured using a hand-held dynamometer. The "break method" will be used for all measurements. To employ this technique, the examiner gradually overcomes the force exerted by the patient until the extremity gives way. All measurements will be performed at least three times, with recovery intervals of at least 10 seconds. The peak forces (in Newtons) will be recorded and mean values of three technically correct measurements will be taken for analysis.

    Measured: 1,5 year

  2. Intima media thickness will be measured with vascular ultrasound

    Vascular damage will be determined with the intima-media thickness (IMT) of the common carotid artery and femoral artery, performed with an Ultrasound technique.

    Measured: 1,5 year

  3. Cholesterol levels, measured in blood

    Measured in blood, in mmol/L

    Measured: 1,5 year

  4. Triglyceride levels, measured in blood

    Measured in blood, in mmol/L

    Measured: 1,5 year

  5. Glucose levels, measured in blood

    Measured in blood, in mmol/L

    Measured: 1,5 year

  6. Body mass index, calculated with formula (see below)

    BMI (body mass index): weight in kilograms divided by height in meters squared

    Measured: 1,5 year

  7. Health related quality of life measured with the EORTC QLQ-C30

    Quality of life will be measured with the European Organization for Research and Treatment of Cancer (EORTC), Quality of Life Questionnaire Core 30 (QLQ-C30) version 3.0 questionnaire

    Measured: 1,5 year

  8. Patient reported self-efficacy measured using the ALCOS instrument

    Patient reported general self-efficacy, measuring the patients' expectations of their general capacities, will be evaluated using the Dutch version of the General Self-Efficacy Scale (GSES), the "Algemene Competentie Schaal" (ALCOS)

    Measured: 1 year

  9. Patient reported fatigue measured with the Multi-dimensional Fatigue Inventory

    The Multi-dimensional Fatigue Inventory is a validated 20-item questionnaire on different domains of fatigue

    Measured: 1,5 year

  10. Patient reported physical activity level with the PASE questionnaire

    Physical activity will be assessed with the Sum score of the Physical Activity Scale for the Elderly questionnaire (PASE). This questionnaire consists of questions on leisure time, household and work-related activities.

    Measured: 1,5 year

  11. DNA collection

    Whole blood will be drawn of patients and collected in EDTA tubes. DNA isolations and the Global Screening Array will be performed at the Human Genomics Facility (HuGeF) of the Genetic Laboratory of the Department of Internal Medicine at Erasmus MC, Rotterdam, the Netherlands

    Measured: 1,5 year

  12. Diffusion capacity of the lungs

    Corrected for hemoglobin.

    Measured: 1,5 year

  13. Forced vital capacity (FVC) will be assessed by use of dynamic spirometry

    Measured by means of dynamic spirometry

    Measured: 1,5 year

  14. Forced expiratory volume in one second (FEV1) will be assessed by use of dynamic spirometry,

    Measured by means of dynamic spirometry

    Measured: 1,5 year

  15. FEV1/FVC ratio will be assessed by use of dynamic spirometry,

    Measured by means of dynamic spirometry

    Measured: 1,5 year

  16. Senescence with markers of the senescence- associated secretory phenotype

    Senescence will be measured in a subset of testicular cancer patients.

    Markers of scenescence will be obtained from a skin biopsy and fat biopsy. Also, additional blood samples will be assessed to establish markers of the senescence- associated secretory phenotype.

    Measured: 1,5 year

  17. Cardiac function with echocardiography (Ultrasound technique)

    Cardiac function will be measured at baseline and at the final measurement (e.g. left ventricular ejection fraction)

    Measured: 1,5 year

  18. Body composition will be assessed with a DEXA scan

    With the DEXA scan, measurements of body composition will be obtained.

    Measured: 1,5 year

  19. PAI-antigen, measured in blood serum

    Endothelial activation will be determined with PAI antigen in blood serum, in ug/L

    Measured: 1,5 year

  20. t-PA, measured in blood serum

    Endothelial activation will be determined with t-PA antigen in blood serum, in ug/L

    Measured: 1,5 year

  21. Factor VIII, measured in blood serum

    Endothelial activation will be determined with factor VIII in blood serum, in %

    Measured: 1,5 year

  22. Von Willebrand factor, measured in blood serum

    Endothelial activation will be determined with von Willebrand facor in blood serum, in %

    Measured: 1,5 year

  23. Fibrinogen, measured in blood serum

    Endothelial activation will be determined with fibrinogen in blood serum, in g/L

    Measured: 1,5 year

  24. Advanced glycation end products (AGEs) will be determined by measuring skin auto fluorescence.

    Advanced glycation end products will be measured with an AGEreader

    Measured: 1,5 year

  25. Blood pressure, measured with a blood pressure cuff

    Systolic and diastolic blood pressure in mmHg

    Measured: 1,5 years

  26. Fat percentage with skinfold measurement

    Skinfold measurement of biceps, triceps, sub scapula and supra iliaca

    Measured: 1.5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jul 2012 (estimated)
  2. Study start24 Jan 2013
  3. Primary completion22 Oct 2020
  4. Study completion22 Oct 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
266 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01642680
Sponsor's protocol ID
2012-0010
Other IDs
41087
Acronym
ACT
Status last verified
May 2024
First submitted
4 Jul 2012
Last updated
6 May 2024
Results posted
No
Data monitoring committee
No

Publications

  • van der Schoot GGF, Ormel HL, Westerink NL, Wempe JB, Lefrandt JD, May AM, Vrieling AH, Meijer C, Gietema JA, Walenkamp AME. Physical exercise in patients with testicular cancer treated with bleomycin, etoposide and cisplatin chemotherapy: pulmonary and vascular endothelial function-an exploratory analysis. J Cancer Res Clin Oncol. 2023 Dec;149(19):17467-17478. doi: 10.1007/s00432-023-05469-5. Epub 2023 Oct 27.

    PubMed 37889308
  • van der Schoot GGF, Ormel HL, Westerink NL, May AM, Elias SG, Hummel YM, Lefrandt JD, van der Meer P, van Melle JP, Poppema BJ, Stel JMA, van der Velden AWG, Vrieling AH, Wempe JB, Ten Wolde MG, Nijland M, de Vries EGE, Gietema JA, Walenkamp AME. Optimal Timing of a Physical Exercise Intervention to Improve Cardiorespiratory Fitness: During or After Chemotherapy. JACC CardioOncol. 2022 Oct 18;4(4):491-503. doi: 10.1016/j.jaccao.2022.07.006. eCollection 2022 Nov.

    PubMed 36444224

Questions about this trial

What is this clinical trial studying?

A study testing A tailored physical activity program during chemotherapy and A tailored physical activity program after chemotherapy in people with Metabolic Syndrome and Vascular Disorders, run by University Medical Center Groningen at 1 site in Netherlands.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference in VO2 peak between the groups after completion of the PA program, measured by cardiopulmonary exercise testing (CPET). (time frame: 1,5 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01642680, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2024.

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