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Lung CancerNCT05053997

Navigate - Improving Survival and Quality of Life in Vulnerable Lung Cancer Patients

A study testing NAVIGATE in people with Lung Cancer, run by Zealand University Hospital at 6 sites in Denmark.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Half of patients with lung cancer face a limited life span of one-year survival, which is characterized by severe physical and psychological symptoms. Differences in stage, comorbidity but also treatment may explain a large proportion of the social inequality in lung cancer survival. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Lung Cancer
What is being tested?
NAVIGATE
Could I receive a placebo?
No, everyone receives an active treatment
How many people
250 participants
Where
6 sitesDenmark
Study dates
1 Mar 2022to 31 Dec 2026
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
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years of age
  • Diagnosed with NSCLC at all stages regardless of treatment intension at the participating departments
  • Performance status ≤ 2
  • Vulnerable according to pre-defined criteria

Who cannot join

  • Severe untreated psychiatric disorder (e.g. psychosis) or cognitive problems (e.g. dementia) preventing informed consent
  • Not able to receive treatment
  • Not able to read and understand Danish -

Trial locations and contacts

6 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Rikke Langballe, PhD contact

+45 35 25 79 72

ril@cancer.dk

Randi V Karlsen, MEd contact

+45 35 25 76 65

randi@cancer.dk

6 sites in 1 country

Denmark6 sites, 6 recruiting
  • Aalborg University Hospital

    Aalborg

    Tine Krogh Mcculloch, tine.mcculloch@rn.dk

    Recruiting
  • Gødstrup Hospital

    Herning

    Hanne Linnet, hansin@rm.dk

    Recruiting
  • Odense University Hospital

    Odense

    Christian Borbjerg Laursen, Christian.B.Laursen@rsyd.dk

    Line Larsen, Line.Larsen2@rsyd.dk

    Recruiting
  • Zealand University Hospital

    Roskilde

    Mads Nordahl Svendsen, mnsv@regionsjaelland.dk

    Recruiting
  • Sønderborg Sygehus

    Sønderborg

    Kim Wedervang

    Kim.Wedervang@rsyd.dk

    Recruiting
  • Vejle Sygehus

    Vejle

    Ole Hilberg, Ole.Hilberg@rsyd.dk

    Kirsten Jones, Kirsten.Jones@rsyd.dk

    Recruiting

Other trials in Denmark

About this study

Official title: NAVIGATE - Improving Survival and Quality of Life in Vulnerable Lung Cancer Patients Through Nurse Navigation, Symptom Monitoring and Exercise: Study Protocol for a Multicenter Randomized Controlled Trial

Half of patients with lung cancer face a limited life span of one-year survival, which is characterized by severe physical and psychological symptoms. Differences in stage, comorbidity but also treatment may explain a large proportion of the social inequality in lung cancer survival. Some vulnerable patients may not receive first line treatment as planned either due to poor performance status or if they are not able to adhere to treatment appointments. Knowing how to navigate the health system may be a barrier preventing vulnerable patients in receiving optimal treatment. The primary aim of this randomised, controlled trial is to test whether a nurse-led individually tailored program including systematic screening of symptoms using PROs and a physical training program will significantly improve a composite outcome of survival and quality of life as the primary outcome among vulnerable lung cancer patients compared with standard care. Secondary outcomes include adherence to cancer treatment, symptom burden and overall survival.

Read the detailed description

During a period of 3 years and 10 months, consecutive newly diagnosed (< 1 week) lung cancer patients will be pre-screened for eligibility and invited to participate at departments of oncology or respiratory medicine in Denmark. Participants (N=250) will be randomized (1:1) to standard treatment plus the intervention (intervention group) or standard treatment (control group) and followed for 1 year. Patients randomized to the control group will receive standard treatment and care consisting of a nurse and a physician, who sees the patient at treatment schedules and during follow-up, i.e. every 3 months for the first 2 years and subsequently annually up to 5 years.

Data will be collected from the intervention and the control group at baseline within 6 weeks after diagnosis, and 3, 6 months and 12 months after diagnosis. Physical tests will be performed at baseline and after 3 and 6 months. Baseline physical tests will be allowed after randomization if patients have difficulties in attending the physiotherapy department within 6 weeks after their diagnosis. Considering that participating patients are vulnerable with limited resources we will proactively support patients in responding to questionnaires electronically, on paper or via telephone as per patient's preference allowing evaluation of the primary and secondary outcomes as well as covariates and mechanisms. The treatment factors will be obtained from the lung cancer clinical database and individual medical journals. In order to develop cost utility analyses, information on use of health services will be retrieved from the national registers.

Conditions
Lung Cancer
Being tested
NAVIGATE
Medical subject headings
Lung Neoplasms

What participants receive

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

  • NAVIGATEBehavioural

    Patients' symptoms are systematically monitored by use of bi-weekly patient reported outcomes and nurse navigators will initiate appropriate actions in terms of medical treatment or guidance of self-management strategies. Nurse navigators will motivate and support patients in health behavior changes and in selfmanaging their treatment and symptoms, and, if relevant, refer to existing rehabilitation services at the hospital or at the local rehabilitation center. Physiotherapists will supervise a training program aimed at improving patients' physical function and thus potentially surgery and overall treatment adherence and outcomes.

Study groups in NCT05053997
Study groupRoleWhat they receive
NAVIGATE intervention armExperimentalNurse navigation
Receives: Behavioral: NAVIGATE
Navigate control armNo interventionStandard treatment and care

What is being measured

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

  1. A hierarchical composite outcome of survival and global quality of life

    Measured from death from all causes and the Global Health Status (a subscale of EORTC QLQ-C30)

    Measured: 3 months from randomization

Secondary outcomes (24)
  1. Overall survival

    Measured by death from all causes

    Measured: 3 months from randomization

  2. Overall survival

    Measured by death from all causes

    Measured: 6 months from randomization

  3. Overall survival

    Measured from death from all causes

    Measured: 12 months from randomization

  4. Adherence to cancer treatment

    Measured by date of skipped treatments or delays if any, and dose administered

    Measured: 3 months from randomization

  5. Adherence to cancer treatment

    Measured by date of skipped treatments or delays if any, and dose administered

    Measured: 6 months from randomization

  6. Adherence to cancer treatment

    Measured by date of skipped treatments or delays if any, and dose administered

    Measured: 12 months from randomization

  7. Symptom burden and health related quality of life

    Measured by EORTC Questionnaire Core 30 (QLQ-C30) and the lung module (QLQ-LC13).

    The QLQ-C30 questionnaire consists of 30 questions with five functional scales (physical, role, cognitive, emotional and social), three symptom scales, a global health status / QoL scale, and six single items.

    The QLQ-LC13 module comprises both multi-item and single-item measures of lung cancer-associated symptoms (coughing, haemoptysis, dyspnoea and pain) and side-effects from conventional chemo- and radiotherapy (hair loss,neuropathy, sore mouth and dysphagia).

    All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems.

    Measured: 3 months from randomization

  8. Symptom burden and health related quality of life

    Measured by EORTC Questionnaire Core 30 (QLQ-C30) and the lung module (QLQ-LC13).

    The QLQ-C30 questionnaire consists of 30 questions with five functional scales (physical, role, cognitive, emotional and social), three symptom scales, a global health status / QoL scale, and six single items.

    The QLQ-LC13 module comprises both multi-item and single-item measures of lung cancer-associated symptoms (coughing, haemoptysis, dyspnoea and pain) and side-effects from conventional chemo- and radiotherapy (hair loss, neuropathy, sore mouth and dysphagia).

    All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems.

    Measured: 6 months from randomization

  9. Symptom burden and health related quality of life

    Measured by EORTC Questionnaire Core 30 (QLQ-C30) and the lung module (QLQ-LC13).

    The QLQ-C30 questionnaire consists of 30 questions with five functional scales (physical, role, cognitive, emotional and social), three symptom scales, a global health status / QoL scale, and six single items.

    The QLQ-LC13 module comprises both multi-item and single-item measures of lung cancer-associated symptoms (coughing, haemoptysis, dyspnoea and pain) and side-effects from conventional chemo- and radiotherapy (hair loss,neuropathy, sore mouth and dysphagia).

    All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems.

    Measured: 12 months from randomization

  10. Quality of life (QOL) measured by EuroQol EQ-5D-5L

    EQ-5D-5L measures individual generic health status using 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and each dimension has 5 levels depending on severity of symptoms (1 no problems, 5 extreme problems) and a VAS (visual analogue scale). The scores can then be converted into a single index number. The index value will be used for calculation of quality-adjusted life years (QALYs) for a health economic analysis of the intervention.

    Measured: 3 months from randomization

  11. Quality of life (QOL) measured by EuroQol EQ-5D-5L

    EQ-5D-5L measures individual generic health status using 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and each dimension has 5 levels depending on severity of symptoms (1 no problems, 5 extreme problems) and a VAS (visual analogue scale). The scores can then be converted into a single index number. The index value will be used for calculation of quality-adjusted life years (QALYs) for a health economic analysis of the intervention.

    Measured: 6 months from randomization

  12. Quality of life (QOL) measured by EuroQol EQ-5D-5L

    EQ-5D-5L measures individual generic health status using 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and each dimension has 5 levels depending on severity of symptoms (1 no problems, 5 extreme problems) and a VAS (visual analogue scale). The scores can then be converted into a single index number. The index value will be used for calculation of quality-adjusted life years (QALYs) for a health economic analysis of the intervention.

    Measured: 12 months from randomization

  13. Health behavior

    Measured by single-items questions related to physical activity, alcohol consumption and smoking behavior

    Measured: 3 months from randomization

  14. Health behavior

    Measured by single-items questions related to physical activity, alcohol consumption and smoking behavior.

    Measured: 6 months from randomization

  15. Health behavior

    Measured by single-items questions related to physical activity, alcohol consumption and smoking behavior.

    Measured: 12 months from randomization

  16. Self-efficacy and self-activation

    Measured by single items from Patient Activation Measure (PAM) and Health Education Impact Questionnaire (HEIQ)

    Measured: 3 months from randomization

  17. Self-efficacy and self-activation

    Measured by single items from Patient Activation Measure (PAM) and Health Education Impact Questionnaire (HEIQ)

    Measured: 6 months from randomization

  18. Self-efficacy and self-activation

    Measured by single items from Patient Activation Measure (PAM) and Health Education Impact Questionnaire (HEIQ)

    Measured: 12 months from randomization

  19. Rehabilitation services

    Measured by single item question

    Measured: 3 months from randomization

  20. Rehabilitation services

    Measured by single item question

    Measured: 6 months from randomization

  21. Rehabilitation services

    Measured by single item question

    Measured: 12 months from randomization

  22. Process evaluation

    Evaluation by participant-observations during training and patient sessions with subsequent qualitative semi-structured interviews with participants about their experience of the intervention components; however, only among participants who provide informed consent for this. Focus group interviews with nurse navigators and physiotherapists will be conducted about their perceptions of the intervention (facilitators and barriers).

    Additionally, evaluation of intervention components will be measured using quantitative single-items questions

    Measured: 3 months from evaluation

  23. Process evaluation

    Evaluation by participant-observations during training and patient sessions with subsequent qualitative semi-structured interviews with participants about their experience of the intervention components; however, only among participants who provide informed consent for this. Focus group interviews with nurse navigators and physiotherapists will be conducted about their perceptions of the intervention (facilitators and barriers).

    Additionally, evaluation of intervention components will be measured using quantitative single-items questions.

    Measured: 12 months from evaluation

  24. Cost-effectiveness

    Evaluation by health care costs and QALYs (Quality Adjusted Life Years) between the two groups.

    Measured: 12 months from randomization

Timeline

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

  1. First posted23 Sep 2021
  2. Study start1 Mar 2022
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2026 (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
Masking
None (open label)
Enrolment
250 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05053997
Sponsor's protocol ID
NAVIGATE
Status last verified
Dec 2025
First submitted
13 Sep 2021
Last updated
29 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Langballe R, Svendsen L, Jakobsen E, Dalton SO, Karlsen RV, Iachina M, Freund KM, Leclair A, Jorgensen LB, Skou ST, Ehlers JH, Torenholt R, Svendsen MN, Envold Bidstrup P. Nurse navigation, symptom monitoring and exercise in vulnerable patients with lung cancer: feasibility of the NAVIGATE intervention. Sci Rep. 2023 Dec 20;13(1):22744. doi: 10.1038/s41598-023-50161-w.

    PubMed 38123657
  • Langballe R, Dalton SO, Jakobsen E, Karlsen RV, Iachina M, Freund KM, Leclair A, Nielsen AS, Andersen EAW, Rosthoj S, Jorgensen LB, Skou ST, Bidstrup PE. NAVIGATE: improving survival in vulnerable patients with lung cancer through nurse navigation, symptom monitoring and exercise - study protocol for a multicentre randomised controlled trial. BMJ Open. 2022 Oct 31;12(10):e060242. doi: 10.1136/bmjopen-2021-060242.

    PubMed 36316074

Questions about this trial

What is this clinical trial studying?

A study testing NAVIGATE in people with Lung Cancer, run by Zealand University Hospital at 6 sites 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 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: looking for participants now, as of the sponsor's last update on 29 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites 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?

Contact Rikke Langballe, PhD (+45 35 25 79 72, ril@cancer.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

A hierarchical composite outcome of survival and global quality of life (time frame: 3 months from randomization). 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 NCT05053997, 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 29 Dec 2025.

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