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Breast Cancer FemaleNCT04586517

Effect of Heavy-load Resistance Training During Chemotherapy on Muscle Cellular Outcomes

A study testing Heavy-load resistance training in people with Breast Cancer Female, run by Uppsala University at 1 site in Sweden.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

(Neo-)adjuvant chemotherapy for breast cancer is known to have a negative impact on muscle tissue resulting in reduced aerobic fitness, skeletal muscle mass and strength. Physical exercise during treatment may counteract some of these negative effects. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer Female
What is being tested?
Heavy-load resistance training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteSweden
Study dates
5 Dec 2018to 1 Jan 2023
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
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • women diagnosed with stage I-III breast cancer
  • literate in Swedish
  • scheduled to undergo (neo-)adjuvant chemotherapy with a combination of taxanes and anthracyclines or only one of these treatments

Who cannot join

  • unable to perform basic activities of daily living
  • cognitive disorders or severe emotional instability
  • other disabling comorbidities that might hamper physical training (e.g. severe heart failure, chronic obstructive pulmonary disease, orthopedic conditions, and neurological disorders)

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • Uppsala University Hospital

    Uppsala

Other trials in Sweden

About this study

Official title: Effects of Heavy-load Resistance Training During (Neo-)Adjuvant Chemotherapy on Muscle Cellular Outcomes in Women With Breast Cancer

(Neo-)adjuvant chemotherapy for breast cancer is known to have a negative impact on muscle tissue resulting in reduced aerobic fitness, skeletal muscle mass and strength. Physical exercise during treatment may counteract some of these negative effects. However, the effects of resistance training alone have never been explored. The present study aims to investigate if heavy-load resistance training during (neo-)adjuvant chemotherapy counteracts negative effects on skeletal muscle in women diagnosed with breast cancer. The hypothesis is that (neo-)adjuvant treatment with chemotherapy will reduce muscle fiber size, impair mitochondrial function and increase indicators of cellular stress and that resistance training during treatment will counteract these negative effects. Fifty women recently diagnosed with breast cancer scheduled to start (neo-)adjuvant chemotherapy will be randomized to either an intervention group or a control group. The intervention group will perform supervised heavy-load resistance training twice a week over the course of chemotherapy (approximately 16-weeks) whereas the control group will be encouraged to continue with their usual activities. To increase interest in participation, controls will be invited to a 2-week introduction to the same resistance-training program as the intervention group following completion of chemotherapy. Muscle biopsies from m. vastus lateralis will be collected before the first cycle of chemotherapy, after chemotherapy, and 6 months later (6-month follow-up) for assessment of muscle cellular outcomes. Results from this intervention will provide further knowledge on how chemotherapy affects muscle tissue and how resistance training may counteract immediate and long-term treatment side effects. Results from this intervention will also contribute with knowledge about how to improve exercise programs that are effective for women undergoing chemotherapy against breast cancer.

Read the detailed description

The aim of this study is to investigate the effects of heavy-load resistance training on muscle cellular outcomes in women with breast cancer undergoing (neo-)adjuvant chemotherapy.

More specifically, the investigators' objectives are to

  1. Investigate the effects of a heavy-load resistance training intervention on skeletal muscle fiber cross-sectional area.
  2. Investigate the effects of a heavy-load resistance training intervention on regulators of muscle fiber size, muscle fiber function, cellular stress and mitochondrial function.
  3. Investigate the effects of chemotherapy on skeletal muscle fiber cross-sectional area, regulators of muscle fiber size, muscle fiber function, cellular stress and mitochondrial function.
  4. Explore the effects of heavy-load resistance training on the expression levels of myokines.

This study is a two-armed randomized controlled trial with follow-up at six months. With this design, the investigators can study the main effect and interactions between factors (groups). Participants will be randomized to either an intervention group or a control group.

Participants recently diagnosed with breast cancer will be recruited from Uppsala University Hospital. Based on power calculations, 50 participants will be included. Data will be collected before the first cycle of chemotherapy, after chemotherapy, and 6 months later (6-month follow-up.

Participants in the intervention group will perform supervised heavy-load resistance training twice a week from the week following the start of chemotherapy and throughout the course of treatment, approximately 16 weeks. Sessions will be performed at a public gym and led by trained coaches. The following six exercises will be included in the program: seated leg-press, seated chest press, seated leg-curl, seated row and seated leg-extension performed in machines and seated overhead-press using dumbbells. The first two weeks of the program represent familiarization to the training protocol and 1 RM (Repetition Maximum) tests. During this period, the participants will perform exercises at a light load. After the first 1 RM-test, training will progress in sets and training load before testing of 6- and 10 RM which will provide the participants with individualized loads. Rest periods between sets will be two (6 RM training load) and one minute (10 RM training load) for the two different sessions, respectively. The training load will be adjusted throughout the intervention period. Participants in the control group are encouraged to continue with their activity as usual i.e. maintain their habitual physical activity level and not initiate resistance training during chemotherapy. To increase interest in participation, controls will be invited to a 2-week introduction to the same resistance-training program as the intervention group following completion of chemotherapy and offered a 12-month membership at a local gym, free of charge.

Being tested
Heavy-load resistance training, Control
Keywords
Breast cancer, Resistance training, Chemotherapy, Randomized controlled trial, Muscle biopsies, Cross-sectional fiber area
Medical subject headings
Breast Neoplasms

What participants receive

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

  • Heavy-load resistance trainingOther

    Also called Physical exercise, Physical training

    Supervised heavy-load resistance training during chemotherapy treatment

  • ControlOther

    Also called usual care

    Activity as usual during chemotherapy

Study groups in NCT04586517
Study groupRoleWhat they receive
Intervention groupExperimentalParticipants will receive supervised heavy-load resistance training twice a week during treatment with chemotherapy (approximately 16-weeks). After end of chemotherapy, participants will be encouraged to continue the training program and are provided with 12-month membership at a local gym.
Receives: Other: Heavy-load resistance training
Control groupActive comparatorParticipants will be encouraged to continue with their usual activities during chemotherapy and not start resistance training (approximately 16-weeks). After end of chemotherapy participants will be offered to attend a 2-week introduction to the strength-training program and provided with a 12-month membership at a local gym.
Receives: Other: Control

What is being measured

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

  1. Assessment of changes in muscle fiber cross-sectional area

    Change from baseline in muscle fiber cross-sectional area at 16 weeks. Through immunohistochemical staining of muscle fiber cross-sections will muscle fiber area be assessed for type 1 and type 2 muscle fibers

    Measured: From baseline to the 16 week time-point

Secondary outcomes (9)
  1. Assessment of changes in muscle fiber cross-sectional area

    Change from baseline in muscle fiber cross-sectional area at 6-month follow-up. Through immunohistochemical staining of muscle fiber cross-sections will muscle fiber area be assessed for type 1 and type 2 muscle fibers

    Measured: From baseline to 6-month follow-up

  2. Assessment of changes in satellite cell content in muscle fiber cross-sections

    Change from baseline in satellite cell content in muscle fiber cross-sections at 16 weeks and at 6-month follow-up. Through immunohistochemical staining of muscle fiber cross-sections will satellite cell content be assessed per muscle fiber

    Measured: From baseline to the 16 week time-point and from baseline to 6-month follow-up

  3. Assessment of changes in myonuclei content in muscle fiber cross-sections

    Change from baseline in myonuclei content in muscle fiber cross-sections at 16 weeks and at 6-month follow-up. Through immunohistochemical staining of muscle fiber cross-sections will myonuclei content be assessed per muscle fiber

    Measured: From baseline to the 16 week time-point and from baseline to 6-month follow-up

  4. Assessment of protein levels of regulators of muscle fiber size (proteins involved in muscle protein synthesis and protein degradation (e.i. mTOR, MuRF, S6K1, p70S6k)

    Change from baseline in protein levels of regulators of muscle fiber size at 16 weeks and at 6-month follow-up. Proteins involved in regulation of muscle size (muscle protein synthesis and protein degradation) will be assessed in muscle homogenate using Western blot analysis

    Measured: From baseline to the 16 week time-point and from baseline to 6-month follow-up

  5. Assessment of changes in protein levels of regulators of muscle fiber cellular stress (Heat Shock proteins: Hsp 27, αB-crystalline, Hsp 60 and Hsp 70)

    Change from baseline in protein levels of regulators of muscle fiber cellular stress at 16 weeks and at 6-month follow-up. Proteins involved in protection against cellular stress will be assessed in muscle homogenate using Western blot analysis

    Measured: From baseline to the 16 week time-point and from baseline to the 6-month follow-up

  6. Assessment of changes in protein levels of regulators of mitochondrial function (Citric syntase, Cox 4 and HAD)

    Change from baseline in protein levels of regulators of muscle fiber mitochondrial function at 16 weeks and at 6-month follow-up. Proteins involved in protection/enzymes involved in mitochondrial function will be assessed in muscle homogenate using Western blot analysis

    Measured: From baseline to the 16 week time-point and from baseline to the 6-month follow-up

  7. Assessment of changes in myokines with potential anti-tumor effects

    Change from baseline in protein levels of myokines with potential anti-tumor effects at 16 weeks and at 6-month follow-up. Myokines assossiated with potential anti-tumor effects will be assessed in muscle homogenate using Western blot analysis

    Measured: From baseline to the 16 week time-point and from baseline to the 6-month follow-up

  8. Changes in muscle strength

    Maximal upper- and lower extremity muscle strength will be assessed as one repetition maximum in seated chest-press and seated single-leg press

    Measured: From baseline to the 16 week time-point and from baseline to the 6-month follow-up

  9. Cardiorespiratory fitness

    Cardiorespiratory fitness will be assessed as maximal oxygen uptake during maximal walking/running until exhaustion on a treadmill

    Measured: From baseline to the 16 week time-point and from baseline to the 6-month follow-up

Timeline

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

  1. First posted14 Oct 2020
  2. Study start5 Dec 2018
  3. Primary completion1 Jan 2022
  4. Study completion1 Jan 2023 (estimated)

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
Model description
Parallel assignment
Masking
None (open label)
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04586517
Sponsor's protocol ID
2020-01097
Status last verified
Nov 2022
First submitted
25 Sep 2020
Last updated
2 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ernst M, Wagner C, Oeser A, Messer S, Wender A, Cryns N, Brockelmann PJ, Holtkamp U, Baumann FT, Wiskemann J, Monsef I, Scherer RW, Mishra SI, Skoetz N. Resistance training for fatigue in people with cancer. Cochrane Database Syst Rev. 2024 Nov 28;11(11):CD015518. doi: 10.1002/14651858.CD015518.

    PubMed 39606939
  • Vikmoen O, Strandberg E, Svindland KV, Henriksson A, Mazzoni AS, Johansson B, Jonsson J, Karakatsanis A, Anneback M, Kudren D, Lindman H, Warnberg F, Berntsen S, Demmelmaier I, Nordin K, Raastad T. Effects of heavy-load strength training during (neo-)adjuvant chemotherapy on muscle strength, muscle fiber size, myonuclei, and satellite cells in women with breast cancer. FASEB J. 2024 Jul 15;38(13):e23784. doi: 10.1096/fj.202400634R.

    PubMed 38953567
  • Mazzoni AS, Strandberg E, Borjeson S, Sjovall K, Berntsen S, Demmelmaier I, Nordin K. Reallocating sedentary time to physical activity: effects on fatigue and quality of life in patients with breast cancer in the Phys-Can project. Support Care Cancer. 2023 Feb 4;31(2):151. doi: 10.1007/s00520-023-07614-9.

    PubMed 36738358
  • Strandberg E, Vassbakk-Svindland K, Henriksson A, Johansson B, Vikmoen O, Kudren D, Schauer T, Lindman H, Warnberg F, Berntsen S, Demmelmaier I, Nordin K, Raastad T. Effects of heavy-load resistance training during (neo-)adjuvant chemotherapy on muscle cellular outcomes in women with breast cancer. Medicine (Baltimore). 2021 Mar 12;100(10):e24960. doi: 10.1097/MD.0000000000024960.

    PubMed 33725859

Questions about this trial

What is this clinical trial studying?

A study testing Heavy-load resistance training in people with Breast Cancer Female, run by Uppsala University at 1 site in Sweden.

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 3 inclusion and 3 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: status not confirmed, as of the sponsor's last update on 2 Nov 2022. 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 Sweden. 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?

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?

Assessment of changes in muscle fiber cross-sectional area (time frame: From baseline to the 16 week time-point). 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 NCT04586517, which also lists 4 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 2 Nov 2022.

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