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Prostate CancerPRO-TESTNCT02954783

PROstaTe Cancer - Exercise-STudy (PRO-TEST)

A study testing High Intensity Interval Training in people with Prostate Cancer, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

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

Background and purpose: The purpose of this study is to investigate the effect of exercise on intratumoral natural killer (NK)-cell variability in patients with localized prostate cancer undergoing radical prostatectomy. Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Prostate Cancer
What is being tested?
High Intensity Interval Training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteDenmark
Study dates
Nov 2016to Dec 2019
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 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pathologically verified localized prostate cancer
  • Eligible for curative radical prostatectomy

Who cannot join

  • Any other known malignancy requiring active treatment
  • Performance status > 1
  • Ongoing treatment with beta blockers
  • Physical disabilities precluding physical testing and/or exercise
  • Inability to read and understand Danish

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Center for Physical Activity Research, Copenhagen University Hospital

    Copenhagen, DK-2100

Other trials in Denmark

About this study

Official title: Effect of Different Exercise Regimens on Intratumoral Natural Killer (NK) Cell Variability in Men With Localized Prostate Cancer Undergoing Radical Prostatectomy - a Randomized Controlled Pilot Study

Background and purpose: The purpose of this study is to investigate the effect of exercise on intratumoral natural killer (NK)-cell variability in patients with localized prostate cancer undergoing radical prostatectomy.

The primary hypothesis is that exercise induces epinephrine-mediated intratumoral natural killer (NK)-cell infiltration in patients with localized prostate cancer, and that the infiltration is greater in patients performing High Intensity Interval Training compared to usual care controls.

Read more

Currently there is a lack of randomized controlled trials examining different types of exercise in patients with localized prostate cancer. Moreover there is a need for studies including biological measurements to allow a full assessment of the effect of exercise on diverse biomarkers and mechanistic pathways, which may influence cancer survival.

Subjects: Patients with histologically verified prostate adenocarcinoma scheduled for radical prostatectomy at Urologic Department, Rigshospitalet, Copenhagen, Denmark.

Methods: In this randomized controlled pilot study 30 patients with localized prostate cancer undergoing radical prostatectomy will be included and randomized 2:1 to either High Intensity Interval Training (HIIT) exercise intervention or observational control receiving usual care from inclusion and until planned surgery (radical prostatectomy).

All patients will undergo assessments at inclusion (baseline) and at follow-up after the exercise intervention period (maximum 8 weeks) 3-5 days prior to surgery.

Assessments include: anthropometrics; blood pressure; resting hearth rate; cardiorespiratory fitness by cardiopulmonary exercise test (VO2 peak.); body composition by DXA scan; quality of life by self-report questionnaires; fasting blood sample measuring cholesterol, triglycerides, insulin, c-peptide, HbA1c, glucose, hormones and inflammatory markers.

Biological tissue from tumor (primary prostate biopsies) will be retrieved from the respective local pathological departments and from the perioperative prostate specimen and sent to protocol analyses.

Read the detailed description

The purpose of this study is to investigate the effect of exercise on the variability of intratumoral Natural Killer (NK)-cell infiltration in tumor biopsies taken before and after an exercise intervention in patients randomized 2:1 to one of two study arms: I) High Intensity Interval Training (HIIT) (N=20) or II) usual care, prior to radical prostatectomy.

In addition to this the investigators wish to investigate the effect of HIIT exercise on the infiltration of other immune cells into the tumor, tumor vessel morphology, modulation of tumor-metabolism, -biology and signaling.

Finally the aim is to explore the effect of pre-operative HIIT exercise on physiological (e.g. cardiovascular fitness, body composition, metabolic profile and metabolic inflammatory markers) and psycho-social (e.g. fatigue, emotional well-being, anxiety) endpoints relative to usual care.

Conditions
Prostate Cancer
Being tested
High Intensity Interval Training, Usual Care Observational Control
Keywords
Prostate cancer, Localized, Exercise, Physical activity, Natural killer cells, Immune cells
Medical subject headings
Prostatic Neoplasms, Motor Activity

What participants receive

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

  • High Intensity Interval TrainingBehavioural

    Supervised aerobic High Intensity Interval Training program consisting of 4 weekly sessions of approximately 35 minutes. Patients will perform a test of maximum cardio-respiratory (VO2 peak test). Using the patient's individual wattmax, a personalized exercise program will be prescribed.

    After a light warm-up, patients will perform 25 min of aerobic high intensity interval training on a stationary bicycle, intervals will consist of cycles of HI intervals with 120% of wattmax for 1 min followed by recovery for 3 min at 30% of wattmax. Each session will be supervised by trained instructors to ensure proper technique, and progression in training load.

  • Usual Care Observational ControlBehavioural

    The reference group will receive the standard patient care program as provided by the Department of Urology, Rigshospitalet.This includes information regarding smoking cessation and alcohol reduction and a physiotherapist consultation regarding pelvic floor exercises. This group is allowed to exercise on their own initiative or participate in any standard care hospital- or municipality-based exercise program. This will be monitored by self-report.

Study groups in NCT02954783
Study groupRoleWhat they receive
High Intensity Interval TrainingExperimentalThe HIIT-group will receive usual care plus a supervised aerobic High Intensity Interval Training program consisting of 4 weekly sessions of approximately 35 minutes.
Receives: Behavioral: High Intensity Interval Training
Usual Care Observational ControlActive comparatorPatients randomized to usual care control will receive the standard patient care program as provided by the Department of Urology, Rigshospitalet.
Receives: Behavioral: Usual Care Observational Control

What is being measured

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

  1. Variability in intratumoral Natural Killer (NK)-cell infiltration

    Natural killer (NK)-cell infiltration will be quantified using histological analyses.

    Measured: Primary prostate biopsies and up to 8 weeks

Secondary outcomes (27)
  1. Tumor vessel morphology

    Tumor vessel morphology will be evaluated using histological analyses.

    Measured: Primary prostate biopsies and up to 8 weeks

  2. Tumor-metabolism, - biology and signaling

    Tumor samples will undergo proteomic analyzes in order to uncover potential upregulated biomarkers.

    Measured: Primary prostate biopsies and up to 8 weeks

  3. Changes in immune cells

    Quantification of immune cells will be measured in blood samples by flowcytometry analyses.

    Measured: Baseline and up to 8 weeks

  4. Changes in epinephrine concentration

    Concentrations of epinephrine will be measured in blood samples by radioimmunoassay analyses.

    Measured: Baseline and up to 8 weeks

  5. Changes in nor-epinephrine concentration

    Concentrations of nor-epinephrine will be measured in blood samples by radioimmunoassay analyses.

    Measured: Baseline and up to 8 weeks

  6. Changes in IL-1 concentration

    Concentrations of IL-1 (Interleukin 1) will be measured in blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  7. Changes in IL- 2 concentration

    Concentrations of IL-2 (Interleukin 2) will be measured in fasting blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  8. Changes in IL- 6 concentration

    Concentrations of IL-6 (Interleukin 6) will be measured in fasting blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  9. Changes in IL- 8 concentration

    Concentrations of IL-8 (Interleukin 8) will be measured in fasting blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  10. Changes in IL- 10 concentration

    Concentrations of IL-10 (Interleukin 10) will be measured in fasting blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  11. Changes in IL- 15R alpha complex concentration

    Concentrations of IL- 15Rα (IL- 15 receptor alpha) complex will be measured in blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  12. Changes in Tumor Necrosis Factor alpha (TNFa) concentration

    Concentrations of TNFa will be measured in blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  13. Changes in Interferon Gamma (IFNγ) concentration

    Concentrations of IFNγ will be measured in blood samples by Enzyme-Linked Immunosorbent Assay (ELISA) analyses.

    Measured: Baseline and up to 8 weeks

  14. Changes in Plasma Total-Cholesterol concentrations

    Concentrations of total cholesterol will be measured in fasting blood samples by standard laboratory methods.

    Measured: Baseline and up to 8 weeks

  15. Changes in Plasma LDL-Cholesterol concentrations

    Concentrations of LDL-cholesterol will be measured in fasting blood samples by standard laboratory methods

    Measured: Baseline and up to 8 weeks

  16. Changes in Plasma HDL-Cholesterol concentrations

    Concentrations of HDL-cholesterol will be measured in fasting blood samples by standard laboratory methods

    Measured: Baseline and up to 8 weeks

  17. Changes in Plasma Triglyceride concentrations

    Concentrations of triglycerides will be measured in fasting blood samples by standard laboratory methods

    Measured: Baseline to and up to 8 weeks

  18. Changes in HbA1C (fasting blood samples)

    Concentrations of HbA1C will be measured in fasting blood samples by standard laboratory methods

    Measured: Baseline and up to 8 weeks

  19. Changes in insulin

    Concentrations of Insulin will be measured in fasting blood samples by standard laboratory methods

    Measured: Baseline and up to 8 weeks

  20. Change in body composition

    Body weight and anthropometrics (height, waist and hip circumference) will be assessed using standard procedures. Resting heart rate and blood pressure (Microlife, BPA100) will be determined in a supine position. Body composition (fat mass, bone mass and fat-free mass) and bone mineral density are analyzed by whole-body dual-energy X-ray absorptiometry (DXA) scan (Lunar, Lunar Corporation Madison, Wisconsin, USA). Transverse scans at 1 cm intervals are made from head to toe measuring the absorption of x-ray beams at two different energy levels as these are sent through the body. Since the different chemical compounds in the body absorb the intensity of the X-rays differently, the scan allows for a valid determination of bone mass, fat mass and fat-free/bone-free mass

    Measured: Baseline and up to 8 weeks

  21. Change in VO2peak

    The participants will undergo a maximal graded exercise test on a bicycle ergometer for evaluation of cardiovascular function and determination of the peak oxygen uptake (VO2peak). The test starts with a 5 min warm up at 70 watt (the watts may have to be adjusted to the individual fitness level). Warm up is immediately followed by a 20 watt increase every 1 min until exhaustion. Ventilation and expired gases will be measured during the test via an indirect calorimetric system, and heart rate will be assessed simultaneously.

    Measured: Baseline and up to 8 weeks

  22. Change in wattmax

    The participants will undergo a maximal graded exercise test on a bicycle ergometer for evaluation of cardiovascular function and determination of the maximum watt (wattmax). The test starts with a 5 min warm up at 70 watt (the watts may have to be adjusted to the individual fitness level). Warm up is immediately followed by a 20 watt increase every 1 min until exhaustion. The maximum watt will be calculated.

    Measured: Baseline and up to 8 weeks

  23. Changes in patient-reported Quality of Life - FACT

    Patient reported quality of life is measured by Functional Assessment of Cancer Treatment (FACT)

    Measured: Baseline and up to 8 weeks

  24. Changes in Sleep Quality

    Patient reported sleep quality is measured by the Pittsburgh Sleep Quality Index (PSQI) questionaire.

    Measured: Baseline up to 8 weeks

  25. Changes in Anxiety and Depression

    Patient reported Anxiety and Depression is measured by the Hospital Anxiety and Depression Scale (HADS).

    Measured: Baseline up to 8 weeks

  26. Changes in Physical Activity level

    Patient reported physical activity is measured by the International Physical Activity Questionaire (IPAQ) - short form.

    Measured: Baseline up to 8 weeks

  27. T-cell infiltration

    T-cell infiltration will be quantified using histological analyses.

    Measured: Primary prostate biopsies from baseline and up to 8 weeks

Timeline

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

  1. First posted3 Nov 2016 (estimated)
  2. Study startNov 2016
  3. Primary completionDec 2019
  4. Study completionDec 2019

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
Basic science
Allocation
Randomised
Intervention model
Factorial
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02954783
Sponsor's protocol ID
H-16034670
Acronym
PRO-TEST
Status last verified
Dec 2019
First submitted
28 Oct 2016
Last updated
18 Dec 2019
Results posted
No
Data monitoring committee
No
Individual data sharing
Undecided

Publications

  • Djurhuus SS, Simonsen C, Toft BG, Thomsen SN, Wielsoe S, Roder MA, Hasselager T, Ostergren PB, Jakobsen H, Pedersen BK, Hojman P, Brasso K, Christensen JF. Exercise training to increase tumour natural killer-cell infiltration in men with localised prostate cancer: a randomised controlled trial. BJU Int. 2023 Jan;131(1):116-124. doi: 10.1111/bju.15842. Epub 2022 Jul 18.

    PubMed 35753072

Questions about this trial

What is this clinical trial studying?

A study testing High Intensity Interval Training in people with Prostate Cancer, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

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 2 inclusion and 5 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 18 Dec 2019. 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 Denmark. 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?

Variability in intratumoral Natural Killer (NK)-cell infiltration (time frame: Primary prostate biopsies and up to 8 weeks). 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 NCT02954783, which also lists 1 linked publication.

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 18 Dec 2019.

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