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Breast CancerNeo-trainNCT04623554

Pre-operative Exercise During Neoadjuvant Chemotherapy in Patients With Breast Cancer

A study testing Prehabilitation program in people with Breast Cancer, run by Zealand University Hospital at 1 site in Denmark.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The Neo-Train study is a randomized controlled trial investigating the effects of supervised pre-operative aerobic and resistance exercise in patients with breast cancer during neoadjuvant chemotherapy. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer
What is being tested?
Prehabilitation program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
102 participants
Where
1 siteDenmark
Study dates
23 Jun 2021to 15 Feb 2034
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • Patients newly diagnosed with histologically verified breast cancer and scheduled for neoadjuvant chemotherapy
  • Female gender
  • Aged ≥ 18 years old
  • Signed informed consent

Who cannot join

  • Patients ineligible for or who have declined to receive neoadjuvant chemotherapy
  • Contraindications to magnetic resonance imaging (MRI)
  • Physical or cognitive disabilities preventing exercise or physical testing
  • Inability to read and understand Danish
  • Based on clinical judgement, the physician assesses that the patient is not suitable for inclusion

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Department of Clinical Oncology and Palliative Care, Zealand University Hospital

    Næstved

Other trials in Denmark

About this study

Official title: Neo-train: Pre-operative Exercise During Neoadjuvant Chemotherapy in Patients With Breast Cancer - a Randomized Controlled Trial

The Neo-Train study is a randomized controlled trial investigating the effects of supervised pre-operative aerobic and resistance exercise in patients with breast cancer during neoadjuvant chemotherapy.

Read the detailed description

The long neoadjuvant chemotherapy period in patients with breast cancer brings a time window of opportunity to investigate the potential of pre-operative exercise to increase treatment efficacy with improved tumour regression. A possible improvement in chemotherapy completion, lift in physical function, alleviated toxicities as well as changes in biological markers can also be investigated.

120 patients with newly diagnosed breast cancer who start neoadjuvant chemotherapy will be randomized to the intervention arm (n=60) and control arm (n=60).

Participants in the intervention arm will be prescribed a prehabilitation program consisting of thrice weekly combined supervised aerobic and resistance exercise during the neoadjuvant chemotherapy period. Participants will be screened for psychological distress four times and in case of moderate-severe distress be advised to visit the local Cancer Society Support Center where participants will be assessed and offered free services based on their psychosocial needs and available offers.

Participants in the control arm will receive usual care.

Outcomes will be measured at baseline (diagnosis), during neoadjuvant chemotherapy, during the week before breast surgery, at breast surgery and at 3 months follow up.

The participants will receive the recommended neoadjuvant chemotherapy regimens in Denmark - currently up to 24 weeks. With expected chemotherapy dose delays, the time of breast surgery is expected to be within 30 weeks from baseline. The treatment plans will be individually modified based on tumour response and expected side effects to treatment. A subgroup of participants may change neoadjuvant chemotherapy regimen and be referred to breast surgery early. In these participants, the last measurement during chemotherapy will be used, and the 3 months follow up measurement will still be scheduled at 3 months after breast surgery.

The study procedures will be pre-tested in a pilot study with 6 patients who will all receive the prehabilitation program.

Conditions
Breast Cancer
Being tested
Prehabilitation program
Keywords
Prehabilitation, Pre-operative exercise, Breast cancer, Tumour regression, Neoadjuvant chemotherapy
Medical subject headings
Breast Neoplasms

What participants receive

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

  • Prehabilitation programBehavioural

    The prehabilitation program includes combined high-intensity interval training on a cycle ergometer and machine-based resistance exercise of large muscle groups supervised by a physiotherapist. Exercise sessions will take place in physiotherapy departments at local hospitals or in municipality rehabilitation centres 3 times a week during the neoadjuvant chemotherapy period and ending in the week before breast surgery (maximum estimated 29 weeks depending on number of chemotherapy cycles, dose delays and time of breast surgery). Participants will be screened for psychological distress four times and in case of moderate-severe distress be advised to visit the local Cancer Society Support Center where participants will be assessed and offered free services based on their psychosocial needs and available offers. Participation will be monitored.

Study groups in NCT04623554
Study groupRoleWhat they receive
Intervention armActive comparatorPrehabilitation program
Receives: Behavioral: Prehabilitation program
Control armNo interventionUsual care

What is being measured

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

  1. Tumour size

    Change in the maximum diameter of the tumour visualized by magnetic resonance imaging (MRI).

    Measured: Sequential MRI scans follow the individual treatment plan in a period of up to 30 weeks from baseline (diagnostic MRI before start of neoadjuvant chemotherapy) to MRI performed by the end of the course of neoadjuvant chemotherapy before breast surgery.

Secondary outcomes (29)
  1. Relative dose intensity of neoadjuvant chemotherapy

    Relative dose intensity in percentage defined as the ratio of received mg/m2 per week compared to planned mg/m2 per week according to standard guidelines.

    Measured: Baseline to time of breast surgery estimated up to 30 weeks

  2. Number of participants with neoadjuvant chemotherapy dose reductions

    Measured in percentage

    Measured: Baseline to time of breast surgery estimated up to 30 weeks

  3. Number of participants with neoadjuvant chemotherapy dose delays

    Measured in percentage

    Measured: Baseline to time of breast surgery estimated up to 30 weeks

  4. Number of participants with early discontinuation of neoadjuvant chemotherapy

    Measured in percentage

    Measured: Baseline to time of breast surgery estimated up to 30 weeks

  5. Number of hospital admissions during neoadjuvant chemotherapy

    Measured in percentage

    Measured: Baseline to time of breast surgery estimated up to 30 weeks

  6. Total length of hospital admissions during neoadjuvant chemotherapy

    Measured in days

    Measured: Baseline to time of breast surgery estimated up to 30 weeks

  7. Changes in total body mass

    Changes from baseline measured by bioelectrical impedance analysis.

    Measured: Baseline, during the week before breast surgery, 3 months after breast surgery

  8. Changes in lean body mass

    Changes from baseline measured by bioelectrical impedance analysis.

    Measured: Baseline, during the week before breast surgery, 3 months after breast surgery

  9. Changes in fat mass

    Changes from baseline measured by bioelectrical impedance analysis.

    Measured: Baseline, during the week before breast surgery, 3 months after breast surgery

  10. Changes in physical fitness

    Changes in VO2 max estimated from maximum power output from baseline measured by a progressive cycle ergometer test (watt max test).

    Measured: Baseline, week 13 during neoadjuvant chemotherapy, during the week before breast surgery, 3 months after breast surgery

  11. Changes in muscle strength

    Changes in 1 repetition maximum strength from baseline measured on leg press and pull down.

    Measured: Baseline, week 13 during neoadjuvant chemotherapy, during the week before breast surgery, 3 months after breast surgery

  12. Changes in physical function

    Changes in hand grip strength from baseline measured by hand-held dynamometer in kilograms. Maximum kilograms obtained of 3 measurements on each hand.

    Measured: Baseline, week 13 during neoadjuvant chemotherapy, during the week before breast surgery, 3 months after breast surgery

  13. Changes in level of physical activity

    Changes in activity data measured by a wearable objective measurement device.

    Measured: Baseline, during the week before breast surgery, 3 months after breast surgery

  14. Changes in health-related quality of life

    Changes in self-reported health-related quality of life from baseline assessed on the Functional Assessment of Cancer Therapy - Breast Cancer (FACT-B).

    Measured: Baseline, week 13 during neoadjuvant chemotherapy, during the week before breast surgery, 3 months after breast surgery

  15. Changes in general anxiety

    Changes in self-reported general anxiety from baseline assessed on the Generalised Anxiety Disorder 7-item (GAD-7).

    Measured: Baseline, week 13 during neoadjuvant chemotherapy, during the week before breast surgery, 3 months after breast surgery

  16. Changes in depression

    Changes in self-reported depression from baseline assessed on the Patient Health Questionnaire-9 (PHQ-9).

    Measured: Baseline, week 13 during neoadjuvant chemotherapy, during the week before breast surgery, 3 months after breast surgery

  17. Changes in psychological distress

    Changes in self-reported psychological distress from baseline assessed on the Distress Thermometer (DT).

    Measured: Baseline, week 13 during neoadjuvant chemotherapy, during the week before breast surgery, 3 months after breast surgery

  18. Post-operative referral to and participation in municipal rehabilitation programs

    Frequency of participants referred to municipal rehabilitation, participation and types of activities attended identified from a self-reported questionnaire.

    Measured: Breast surgery to 3 months after breast surgery

  19. Tumour size

    Assessed by doctors' clinical examination of the breast.

    Measured: Sequential clinical examinations of the breast following the individual treatment plan in a period of up to 30 weeks from baseline to time of breast surgery

  20. Tumour size

    Measured by a pathologist from the tumour surgical specimen at breast surgery.

    Measured: At time of breast surgery estimated to take place within 30 weeks from baseline

  21. Pathological response grade

    Assessed by a pathologist from the tumour surgical specimen at breast surgery.

    Measured: At time of breast surgery estimated to take place within 30 weeks from baseline

  22. Tumour infiltrating lymphocyte population

    Description of tumour infiltrating lymphocyte population (percentage of cells) evaluated by a pathologist from the tumour biopsy specimen taken before chemotherapy and tumour surgical specimen at breast surgery.

    Measured: Baseline (pre-chemotherapy) to time of breast surgery estimated up to 30 weeks

  23. Tumour vascularity

    Description of tumour vascularity density and structure evaluated by a pathologist from the tumour biopsy specimen taken before chemotherapy and tumour surgical specimen at breast surgery.

    Measured: Baseline (pre-chemotherapy) to time of breast surgery estimated up to 30 weeks

  24. Liquid biopsies

    Changes in cell free DNA from blood samples. Furthermore, circulating tumour DNA will be investigated if possible.

    Measured: Baseline, approximately week 7, 13 and 19, 3 months after breast surgery

  25. Metabolic and inflammatory markers

    Changes in glucose, hba1c, zinc, magnesium, phosphate and C reactive protein (CRP) levels from blood samples.

    Measured: Baseline, approximately week 13 and 19, 3 months after breast surgery

  26. Cytokines

    Changes in cytokines from blood samples before, during and after neoadjuvant chemotherapy.

    Measured: Baseline, approximately week 13 and 19, 3 months after breast surgery

  27. Cell proliferation

    In vitro cell proliferation response with sera collected from blood samples before and after exercise.

    Measured: Approximately between week 1-4 during neoadjuvant chemotherapy and within 6 weeks before breast surgery

  28. Recurrence

    Incidence of breast cancer recurrence in percent

    Measured: Breast surgery to up to 10 years follow-up after breast surgery

  29. Survival

    Risk of mortality

    Measured: Breast surgery to up to 10 years follow-up after breast surgery

Timeline

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

  1. First posted10 Nov 2020
  2. Study start23 Jun 2021
  3. Primary completion15 Feb 2024
  4. Study completion15 Feb 2034 (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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized controlled trial with an intervention arm and a control arm
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
102 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04623554
Sponsor's protocol ID
REG-074-2020
Acronym
Neo-train
Status last verified
Jan 2026
First submitted
19 Oct 2020
Last updated
3 Feb 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Kjeldsted E, Ammitzboll G, Jorgensen LB, Lodin A, Bojesen RD, Ceballos SG, Rosthoj S, Laenkholm AV, Skou ST, Jack S, Gehl J, Dalton SO. Neo-train: study protocol and feasibility results for a two-arm randomized controlled trial investigating the effect of supervised exercise during neoadjuvant chemotherapy on tumour response in patients with breast cancer. BMC Cancer. 2023 Aug 19;23(1):777. doi: 10.1186/s12885-023-11284-5.

    PubMed 37598196
  • Kjeldsted E, Ammitzboll G, Laenkholm AV, Rasic D, Ceballos SG, Jorgensen LB, Skou ST, Bojesen RD, Lodin A, Tolver A, Rosthoj S, Jack S, Gehl J, Dalton SO. Effects of Supervised Exercise during Neoadjuvant Chemotherapy on Tumor Response in Patients with Breast Cancer (Neo-train): A Randomized Controlled Trial. Clin Cancer Res. 2025 Oct 15;31(20):4265-4277. doi: 10.1158/1078-0432.CCR-25-0416.

    PubMed 40788186

Questions about this trial

What is this clinical trial studying?

A study testing Prehabilitation program in people with Breast Cancer, run by Zealand University Hospital 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 4 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: under way, not looking for participants, as of the sponsor's last update on 3 Feb 2026. 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?

This study is still under way. Results are not available in the source record yet.

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?

Tumour size (time frame: Sequential MRI scans follow the individual treatment plan in a period of up to 30 weeks from baseline (diagnostic MRI before start of neoadjuvant chemotherapy) to MRI performed by the end of the course of neoadjuvant chemotherapy before breast surgery.). 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 NCT04623554, 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 3 Feb 2026.

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