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Breast CancerOPTIMUNENCT03448250

Evaluating a Novel Web-based Intervention for Breast Cancer Survivors

A study testing Optimune and Care-As-Usual in people with Breast Cancer, run by Technical University of Dortmund at 2 sites in Germany.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The trial aims to evaluate the effectiveness of a novel web-based intervention (Optimune), which was designed to introduce relevant cognitive-behavioral therapy (CBT) techniques to women with breast cancer who are past the active eradication phase and free from disease recurrence. Read more about this study

Who is it for?
Ages 30 to 70 years, women only
Conditions the study is for
Breast Cancer
What is being tested?
Optimune and Care-As-Usual
Could I receive a placebo?
No, everyone receives an active treatment
How many people
64 participants
Where
2 sitesGermany
Study dates
16 Mar 2018to 30 Apr 2022
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 30 to 70 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Eligible are women who
  • had breast cancer diagnosed less than 4 years ago, classified as T0-4, N0-1, M0
  • completed acute treatment for breast cancer at least 6 month ago. This applies for surgery, chemotherapy or radiation, whichever occurred last. (Prophylactic treatment with anti-hormones like tamoxifen, aromatase-inhibitors or bisphosphonates is allowed).
  • are competent in German language
  • provide written consent to study procedures
  • are willing to provide the discharge letter from oncology (to verify diagnosis and therapies)

Who cannot join

  • Women are not eligible if they
  • have a prior history of breast cancer (other than the current one) or any other cancer except basal or squamous cell skin cancer
  • suffer from the following autoimmune and/or inflammatory diseases: rheumatoid arthritis, lupus erythematodes, psoriasis, multiple sclerosis or inflammatory breast cancer
  • have a history of schizophrenia, bipolar disorder, or an established diagnosis of borderline personality disorder
  • have elevated current suicide risk
  • routinely attend psychotherapy, either 1:1, group-therapy or web-based interaction (at least two sessions per month)
Show all 9Show fewer
  • practice 5 hours or more of vigorous physical activity per week (e.g. training for marathon)
  • have cognitive impairment
  • abuse alcohol or drugs

Trial locations and contacts

2 sites in 1 country.

Germany2 sites
  • Technical University of Dortmund, Leibniz Research Centre for Working Environment and Human Factors

    Dortmund, 44139

  • University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Section Psychosocial Oncology

    Leipzig, 04103

Other trials in Germany

About this study

Official title: Evaluation of a Web-based Psychological Intervention as add-on to Care as Usual in Breast Cancer Survivors: Effect on Immune Status, Inflammation and Psychometric Outcome

The trial aims to evaluate the effectiveness of a novel web-based intervention (Optimune), which was designed to introduce relevant cognitive-behavioral therapy (CBT) techniques to women with breast cancer who are past the active eradication phase and free from disease recurrence. The present study will test the hypothesis that Optimune has an impact on immune status, markers of inflammation and psychometric outcomes. Therefore, 150 woman with breast cancer will be recruited and randomized to two groups: (1) a control group, in which they may engage with any treatment (Care-as-Usual, CAU) and receive access to Optimune after a delay of 6 months (i.e., CAU/wait list control group), or (2) to a treatment group that immediately receives 12-month access to Optimune and may also use CAU. The primary outcome measure is the effect on inflammatory parameters six month post-baseline.

Read the detailed description

Depression and fatigue is common in breast cancer survivors and its presence is associated with personal suffering, increased inflammatory activity, and worse prognosis. While in the phase of acute treatment many women receive short-term psychological support to better cope with the situation, this is not standard of care in the years following. Web-based psychological interventions are easily accessible and preliminary evidence suggests that such interventions can be effective. However, no trial has yet examined whether a CBT-based internet intervention designed to meet the needs of breast cancer survivors can achieve effects on immune status, inflammation and psychometric outcomes, when offered as adjunct to care as usual.

In this study, the investigators will study treatment effects of the novel web-based program Optimune when added to treatment as usual. Beyond established CBT techniques targeting depression, anxiety, and fatigue, this intervention specifically includes elements that have shown effects on markers of immune status and inflammation, including sleep and stress management (e.g., mindfulness-based techniques) and lifestyle optimization (dietary and physical activity advice). The delivery and training of content is continuously individualized to match users' preferences and needs, based on responses within the program. The intervention is delivered via the internet and protected by individually assigned passwords. The program can be accessed for 365 days after registration.

This randomized controlled trial will include 150 women with breast cancer who are past the active eradication phase and free from disease recurrence. Participants will be recruited from various settings, including web-based advertisement and internet forums/groups. Participants will be randomly assigned to either (1) a control group, in which they receive care as usual (CAU) and are given access to the web-based intervention (Optimune) after a delay of 6 months (i.e., CAU/wait list control group), or (2) a treatment group that may also use CAU and in addition immediately receives 12-month access to the web-based intervention (Optimune). Measurements are collected at pre-treatment (T0) three months (T1), six months (T2), nine months (T3) and twelve months (T4).

Conditions
Breast Cancer
Being tested
Optimune, Care-As-Usual
Medical subject headings
Breast Neoplasms

What participants receive

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

  • OptimuneBehavioural

    Optimune is a web-based psychological intervention developed for women with breast cancer.

  • Care-As-UsualOther

    Participants are free to continue to engage with any treatment they require (i.e., CAU).

Study groups in NCT03448250
Study groupRoleWhat they receive
OptimuneExperimentalOptimune is an web-based psychological intervention for women with breast cancer. Beyond established CBT techniques targeting depression, anxiety, and fatigue, this intervention specifically includes elements that have shown effects on markers of immune status and inflammation, including sleep, stress management (e.g., mindfulness-based techniques) and lifestyle optimization (dietary and physical activity advice). Content is continuously adapted to users' concerns and needs. It contains interactive dialogues that can be accessed via computer or smart-phone, illustrations, audio files and motivating text messages. Optional daily text messages with motivational content accompany the program. The program can be accessed for 365 days after registration.
Receives: Behavioral: Optimune
Care-as-UsualActive comparatorAs in the experimental arm, participants are free to continue to engage with any treatment they require (i.e., CAU). However, they will receive access to Optimune six months post-baseline (i.e., wait list with respect to Optimune access).
Receives: Other: Care-As-Usual

What is being measured

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

  1. concentration of C-reactive protein (CRP)

    Plasma concentration of C-reactive protein (CRP)

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  2. circulating Interleukin (IL) 6

    Plasma concentration of IL-6

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  3. circulating Tumor necrosis factor (TNF)-α

    Plasma concentration of TNF-α

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  4. stimulated IL-6

    Concentration of secreted IL-6 after stimulation of peripheral blood mononuclear cells with Lipopolysaccharide (LPS)

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  5. stimulated TNF-α

    Concentration of secreted TNF-α after stimulation of peripheral blood mononuclear cells with Lipopolysaccharide (LPS)

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

Secondary outcomes (13)
  1. Plasma Concentrations of Cytokines

    Circulating levels (pg/ml) of IL-1β, IFN- α, IFN-γ, MCP-1, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33 will be measured using cytometric bead array (CBA)

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  2. Concentration of secreted Cytokines after Phorbol-12-myristate-13-acetate (PMA) stimulation of peripheral blood mononuclear cells

    Concentrations (pg/ml) of secreted of IL-1β, Interferon (IFN)-α, IFN-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33 after stimulation of peripheral blood mononuclear cells with Phorbol-12-myristate-13-acetate (PMA) will be measured using a cytometric bead array (CBA).

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  3. Concentration of secreted Cytokines after Lipopolysaccharide (LPS) Stimulation of peripheral blood mononuclear cells

    Concentrations (pg/ml) of secreted of IL-1β, IFN- α, IFN-γ, TNF- α, MCP-1, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33 after stimulation of peripheral blood mononuclear cells with LPS will be measured using cytometric bead array (CBA)

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  4. Circulating numbers of Lymphocytes, Monocytes, Granulocytes

    Circulating numbers of Lymphocytes, Monocytes, and Granulocytes (per ul blood) will be measured by 'TruCount' Flow Cytometry.

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  5. Phenotypic analysis of T and NK cell subsets

    We will analyze the distribution of T cell and NK cell subsets by 11 color Flow Cytometry (using the following antibody panels:

    Panel 1 ("NK + T cells + Treg + memory + homing"): KLRG1, CD3, Zombie Yellow, CD8, CD28, CD57, CD56, CD62L, CD197, CD45RA, CD4.

    Panel 2 ("NK + T activation + memory"): KLRG1, CD3, Zombie Yellow, NKG2C, CD56, CD57, CD25, DNAM-1, CD69.

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  6. Cortisol awakening response (CAR)

    Cortisol concentrations from saliva samples taken at time of awakening and 30 and 45 min. after awakening will be measured to determine the Cortisol awakening response (CAR)

    Measured: Change from baseline to 6 months (also assessed at 12 months post-baseline)

  7. Determination of cancer-related fatigue using the Brief Fatigue Inventory Questionnaire

    Fatigue will be measured using the Brief Fatigue Inventory Questionnaire (BFI-9) questionnaire. Scale Range: 0 to 90.

    The BFI is a 9-item, 11-point rating scale. The first three questions measure fatigue severity from 0, indicating "no fatigue," to 10, indicating "as bad as you can imagine," at current, usual, and worst levels. The following six questions assess fatigue interference with daily activities. Response options range from 0, indicating "does not interfere," to 10, indicating, "completely interferes." Interpretation: A global fatigue score can be obtained by averaging all the items on the BFI.

    Higher scores on the BFI correspond to greater self-reported levels of fatigue

    Measured: Change from baseline to 3 months (also assessed at 6, 9 and 12 months post-baseline)

  8. Determination of cancer-related emotional stress

    Cancer-related emotional stress will be measured using the standardized IES-R (Impact of Event Scale) Questionnaire. Scale Range: 0 to 88 The IES-R is a 22-item self-report measure that assesses subjective distress caused by traumatic events. Items are rated on a 5-point scale ranging from 0 ("not at all") to 4 ("extremely"). The IES-R yields a total score (ranging from 0 to 88) and subscale scores can also be calculated for the Intrusion, Avoidance, and Hyperarousal subscales.

    Interpretation: Higher scores correspond to greater self-reported levels of post-traumatic stress.

    Measured: Change from baseline to 3 months (also assessed at 6, 9 and 12 months post-baseline)

  9. Determination of depression

    Depression will be measured using the standardized PHQ-9 (Patient Health Questionnaire). Scale Range: 0 to 27 The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. PHQ-9 scores of 5, 10, 15, and 20 represents mild, moderate, moderately severe and severe depression.

    Interpretation: Higher scores correspond to greater self-reported levels of depression.

    Measured: Change from baseline to 3 months (also assessed at 6, 9 and 12 months post-baseline)

  10. Determination of anxiety

    Anxiety will be measured using the standardized GAD-7 (Generalized Anxiety Disorder) questionnaire. Scale Range: 0 to 21 The GAD-7 is an instrument for screening, diagnosing, monitoring and measuring the severity of anxiety. GAD-7 scores of 5, 10, and 15 represents mild, moderate, and severe anxiety.

    Interpretation: Higher scores correspond to greater self-reported levels of anxiety.

    Measured: Change from baseline to 3 months (also assessed at 6, 9 and 12 months post-baseline)

  11. Determination of fear of progression

    Fear of progression will be measured using the standardized PA-F12 (Fear of progression) questionnaire. Scale Range: 12 - 60 The PAF-12 items are scored on a five-point Likert Scale ranging from 1 ('never') to 5 ('very often'), higher values indicating higher levels of anxiety.

    Interpretation: Higher scores correspond to greater self-reported levels of fear of progression.

    Measured: Change from baseline to 3 months (also assessed at 6, 9 and 12 months post-baseline)

  12. Determination of usefulness of the program

    Usefulness of the program will be measured by a questionnaire

    Measured: Assessed at 3, 6, 9 and 12 months

  13. Determination of Negative Effects

    Negative Effects will be measured using the standardized INEP (Inventory for the Assessment of Negative Effects of Psychotherapy) questionnaire.

    Measured: Assessed at 3, 6, 9 and 12 months

Timeline

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

  1. First posted28 Feb 2018
  2. Study start16 Mar 2018
  3. Primary completion30 Sep 2021
  4. Study completion30 Apr 2022

Why it stopped: Participant recruitment was stopped due to corona pandemic.

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03448250
Sponsor's protocol ID
Optimune Trial
Acronym
OPTIMUNE
Status last verified
Apr 2022
First submitted
7 Feb 2018
Last updated
5 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Anonymized individual participant data shall be made available upon request for projects such as meta-analyses after completion of the study

Questions about this trial

What is this clinical trial studying?

A study testing Optimune and Care-As-Usual in people with Breast Cancer, run by Technical University of Dortmund at 2 sites in Germany.

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 6 inclusion and 9 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: stopped early, as of the sponsor's last update on 5 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Germany. 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 was stopped early (reason given: Participant recruitment was stopped due to corona pandemic.). Results are not available in the source record.

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?

concentration of C-reactive protein (CRP) (time frame: Change from baseline to 6 months (also assessed at 12 months post-baseline)). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 5 May 2022.

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