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Cardio-OncologyReCONCT06302634

Cardio-Oncology Rehabilitation Care Process

An observational study of Cardio-Oncology and Rehabilitation, run by Hospital Clinico Universitario de Santiago at 1 site in Spain.

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

The objective of this observational study is to assess the outcomes of a hospital-based Cardio-Oncology Rehabilitation (CORe) program focused on exercise in cancer patients undergoing cardiotoxic treatment. Read more about this study

Who is it for?
Ages 18 to 70 years
What is being tested?
Exercise-based cardio-oncology rehabilitation
How many people
300 participants
Where
1 siteSpain
Study dates
22 Jun 2022to 22 Jun 2027
How long will I take part?
9 Months
Phase
Observational
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 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Women with breast cancer at high risk of developing cardiotoxicity

Who may be able to join

  • High risk of cancer treatment-related cardiotoxicity
  • Possibility of completing a cardio-onco rehabilitation program (centre-based or home-based) and programmed visits.
  • Providing written informed consent.

Who cannot join

  • Patients with physical or mental limitation to carry out an exercise program.

Trial locations and contacts

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

Estíbaliz Díaz-Balboa, PT contact

+34 981950747

estibaliz.diaz.balboa@sergas.es

Bibiana Villamayor-Blanco, MD, PhD contact

+ 34 981950744

bibiana.villamayor.blanco@sergas.es

Spain1 site, 1 recruiting
  • Hospital Clínico Universitario de Santiago

    Santiago de Compostela, A Coruña, 15706

    Carlos Peña-Gil, MD, PhD, +34 981 950 778, carlos.pena.gil@sergas.es

    Estíbaliz Díaz-Balboa, +34 981950747, estibaliz.diaz.balboa@sergas.es

    Recruiting

Other trials in Spain

About this study

Official title: Hospital-based Cardio-Oncology Rehabilitation Care Process for Cardiovascular Health in Cancer Patients

The objective of this observational study is to assess the outcomes of a hospital-based Cardio-Oncology Rehabilitation (CORe) program focused on exercise in cancer patients undergoing cardiotoxic treatment. This evaluation will be conducted by analyzing disease-related health indicators, functional capacity, and quality of life. Patients at risk of cardiotoxicity attending the Cardio-Onco-Hematology Unit will be offered the exercise program, which includes two modalities: in-person (center-based) and remote (home-based) options. The assignment to either modality is non randomized, based on the functional assessment conducted in the Rehabilitation Unit and the agreement between healthcare professional and patient. All participants will perform a 3-month supervised exercise intervention. There are 3 time points for assessment: at baseline (T0), 3-month after the exercise program (T1) and follow-up at 9 months from baseline (T2).

Read the detailed description

Advancements in pharmacological cancer treatment have significantly improved prognosis and increased survival rates. However, the chronicity of treatment-related side effects or associated comorbidities may be exacerbated. Various chemotherapy treatments are associated with the potential development of cardiovascular diseases, such as cardiotoxicity, which stands as a main cause of death among women with early-stage breast cancer. Additionally, other side effects, such as fatigue, loss of muscle mass, insomnia, lymphedema, and cognitive impairments, can markedly decline the quality of life of these patients.

The comprehensive care of oncology patients should extend beyond curative interventions like surgery, radiotherapy, or chemotherapy. It must encompass other aspects, such as psychological support, social support and therapeutic exercise programs to enhance the overall treatment experience and improve the quality of life. Exercise has proven to reduce mortality, morbidity, and the risk of recurrence, improving treatment tolerance and reducing interruptions, thereby promoting adherence. Supervised exercise programs are increasingly recognized as a low-cost and a side-effect-free "polypill". However, they have not yet been integrated into the standard care of patients with cancer.

The inherited experience from multimodal Cardiac Rehabilitation (CR) programs with a comprehensive assessment and a multifaceted intervention with exercise programs as a central component; could be extended to cancer patients, resulting in a CORe program (ReCO in Spanish) by utilizing available CR programs in all healthcare areas.

The proposed CORe care process is grounded in the prior experience with the ONCORE trial (Clinicaltrials.gov: NCT03964142), which has helped in the implementation of new, structured, and controlled healthcare service, ensuring higher quality, safety, and efficiency in healthcare.

The implementation of the CORe program will take place at the University Hospital Complex of Santiago de Compostela (CHUS), under the coordination of the Cardiology, Oncology, and Rehabilitation services. The management of participants data and the establishment of indicators should facilitate the monitoring of the process and the evaluation of the results of clinical interventions.

The goal of this project is to assess the outcomes of a CORe care process through the analysis of health-related indicators, functional capacity, and the quality of life of breast cancer participants attending the Cardio-Oncology Unit.

Being tested
Exercise-based cardio-oncology rehabilitation
Keywords
cardio-oncology rehabilitation; cardiovascular prevention; exercise; cancer
Medical subject headings
Cardiovascular Diseases, Motor Activity, Neoplasms

What participants receive

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

  • Exercise-based cardio-oncology rehabilitationOther

    Within the multidisciplinary approach of cardio-oncology rehabilitation, the exercise program will include recommendation and supervision of strength, aerobic and mobility exercises.

Study groups in NCT06302634
Study groupRoleWhat they receive
Center-Based Cardio-Oncology Rehabilitation (CBCORe)Therapeutic exercise program supervised by a physiotherapist. 2 days/week, duration 1h, in the Cardiac Rehabilitation ward.
Receives: Other: Exercise-based cardio-oncology rehabilitation
Home-Based Cardio-Oncology Rehabilitation (HBCORe)Recommendation of physical exercise and motivational interview through telephone follow-up every 2 weeks by the physiotherapist.
Receives: Other: Exercise-based cardio-oncology rehabilitation

What is being measured

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

  1. Change in left ventricular systolic function quantified by left ventricular ejection fraction and global longitudinal strain by transthoracic echocardiography

    Fall of 10 absolute percentage points of left ventricular ejection fraction from baseline or with final value below 53% or global longitudinal strain fall >15% with respect to baseline

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2); every year after study completion up to a maximum of 5 years

  2. Increased cardiac biomarkers (Troponin I and BNP/NT-proBNP)

    cTnI/T>percentil 99, BNP≥35 pg/mL, NT-proBNP≥125 pg/mL

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2); every year after study completion up to a maximum of 5 years

  3. Decrease in functional capacity assessed by estimated VO2peak

    To estimate VO2peak, the ONCORE equation developed in the following article is used: Díaz-Balboa, E., González-Salvado, V., Rodríguez-Romero, B. et al. Thirty-second sit-to-stand test as an alternative for estimating peak oxygen uptake and 6-min walking distance in women with breast cancer: a cross-sectional study. Support Care Cancer 30, 8251-8260 (2022). https://doi.org/10.1007/s00520-022-07268-z

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  4. Change in cardiovascular risk profile as assessed by the presence or absence of classic cardiovascular risk factors.

    Dyslipidemia, Diabetes mellitus, Arterial Hypertension, Smoking status

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2); every year after study completion up to a maximum of 5 years

  5. Changes in fasting blood glucose

    Value of fasting blood glucose (mg/dL) in blood tests

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2); every year after study completion up to a maximum of 5 years

  6. Changes in total low-density lipoprotein (LDL) and total cholesterol (TC) levels

    Value of LDL >160 mg/dL or CT> 200 mg/dL in blood tests

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2); every year after study completion up to a maximum of 5 years

  7. Change in haemoglobin

    Value of haemoglobin (g/dL) in blood tests

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2); every year after study completion up to a maximum of 5 years

  8. Significant cardiovascular and non-cardiovascular adverse effects during treatment.

    number of participants with significant cardiovascular and non-cardiovascular adverse effects throughout the study, threatening life, requiring admission, prolonging hospitalization, being clinically relevant or causing chemotherapy interruptions.

    Measured: Date of the event throughout the study.

Secondary outcomes (14)
  1. Change in health-related quality of life assessed by the Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACT-B+4) questionnaire.

    Score achieved in the Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACT-B+4) questionnaire, a specific validated scale to assess quality of life of women with breast cancer. It comprises 27 items within 5 areas of assessment: physical well-being (7 items), social and family environment (7 items), emotional well-being (7 items), functional well-being (6 items) and worries related to the diagnosis and treatment of the disease (9 items). Each item is scored by means of a Likert scale from 0 to 5, with higher scores representing better results. The total score is obtained by adding the scores for each item, and ranges from a minimum of 0 (worst possible result) to a maximum of 146 (best possible result).

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  2. Change in localized lower limb functional capacity assessed by number of repetitions performed within 30 seconds in the sit-to-stand test.

    Number of repetitions in the sit-to-stand test within 30 seconds.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  3. Change in lower limb strength measured by squat dynamometry (kg).

    Kilograms by dynamometry.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  4. Change in biceps strength by dynamometry (kg).

    Kilograms by dynamometry.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  5. Change in perimeter (cm) of the right thigh 5cm above the upper edge of the patella

    Thigh perimeter measured with a tape measure in cm.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  6. Changes in peak expiratory flow

    The peak expiratory flow in units of liters per minute (L/min), measured with a peak flow meter.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  7. Change in upper limb strength measured by dynamometry (kg).

    Grip strength (both right and left side) and bilateral biceps strength in kilograms by dynamometry.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  8. Change in anthropometric parameters: weight in kg.

    Weight measured in kg.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  9. Change in anthropometric parameters: Body mass index (BMI) in kg/m^2

    Weight and height will be combined to report BMI in kg/m^2

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  10. Change in anthropometric parameters: abdominal circumference in cm.

    Abdominal perimeter measured with a tape measure in cm.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  11. Change in resting heart rate measured by pulse oximetry (beats per min).

    Resting heart rate by pulse oximetry (beats per min).

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  12. Change in resting blood pressure (mmHg) measured by a blood pressure monitor.

    Resting blood pressure by a blood pressure monitor in mmHg.

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2)

  13. Change in physical activity assessed by the score in the Godin Leisure Test Exercise Questionnaire (GLTEQ).

    Score achieved in the Godin Leisure Test Exercise Questionnaire (GLTEQ) for quantification of physical activity. Activities are classified into three subgroups: "strenuous," "moderate," and "light." The scores corresponding to the energy expenditure (metabolic equivalent (MET)) are obtained by multiplying activities performed for more than 15 min in a week with their coefficients. The numbers represent the MET intensity values (strenuous/ exhausting exercises: 9 METs, moderate exercises: 5 METs, and light exercises: 3 METs).The increasing scores are associated with the increasing number of exercise behaviors, providing references about the contribution of physical activity to health: the activity score of 24 units and more as active (substantial benefits); the activity score of 14-23 units as moderately active (some benefits); and the activity score of 13 units and less as inactive (less substantial or low benefits).

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2).

  14. Change in cardiovascular treatment by its presence or absence.

    ACE Inhibitor/ARB II; Beta-blocker; Statins; Ezetimibe

    Measured: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2).

Timeline

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

  1. First posted12 Mar 2024
  2. Study start22 Jun 2022
  3. Primary completion22 Jun 2027 (estimated)
  4. Study completion22 Jun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
300 participants (estimated)
Target duration
9 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT06302634
Sponsor's protocol ID
ReCO
Other IDs
2022/137
Acronym
ReCO
Status last verified
Mar 2024
First submitted
4 Mar 2024
Last updated
15 Mar 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Shared in the institutional repository of SERGAS (RUNA), upon request

Questions about this trial

What is this clinical trial studying?

An observational study of Cardio-Oncology and Rehabilitation, run by Hospital Clinico Universitario de Santiago at 1 site in Spain.

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 1 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 15 Mar 2024. 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 Spain. 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 Estíbaliz Díaz-Balboa, PT (+34 981950747, estibaliz.diaz.balboa@sergas.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in left ventricular systolic function quantified by left ventricular ejection fraction and global longitudinal strain by transthoracic echocardiography (time frame: Baseline (T0); 3 months after completing the exercise program (T1); follow-up at 9 months from baseline (T2); every year after study completion up to a maximum of 5 years). The study lists 8 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 15 Mar 2024.

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