AzTrials
AzTrials

OncologyPRIMERNCT07680556

Promoting Response to IMmunotherapy by Exercise in Patients With Advanced Renal Cell Carcinoma

A study testing HIIT in people with Oncology, run by Radboud University Medical Center at 2 sites in Netherlands.

Recruiting

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

Sites and contacts
Official record
Search all trials

Trial summary

The primary aim of this study is to evaluate the feasibility of a supervised high intensity interval training (HIIT) program during first-line dual immune checkpoint inhibitor (ICI) therapy (nivolumab plus ipilimumab) in patients with advanced renal cell carcinoma (RCC). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Oncology
What is being tested?
HIIT
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
2 sitesNetherlands
Study dates
22 Jul 2026to 1 Sep 2028
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.
  • Diagnosed with advanced RCC with indication for standard-of-care dual ICI treatment.
  • Able and willing to give written informed consent.

Who cannot join

  • Life expectancy <6 months.
  • Unable to perform basic activities of daily living such as walking.
  • Presence of cognitive impairment or severe emotional instability (e.g. schizophrenia, Alzheimer's disease, alcohol addiction), at the discretion of the investigator.
  • Presence of other disabling comorbidities that may interfere with the ability to perform physical exercise (e.g., heart failure, chronic obstructive pulmonary disease (COPD, GOLD stage 3 or 4), orthopaedic conditions, or neurological disorders such as hernia, paresis, amputation or active rheumatoid arthritis), at the discretion of the investigator.
  • Current participation in structured vigorous aerobic and/or resistance exercise ≥ 2 times per week at a level comparable to the intervention

Trial locations and contacts

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

Netherlands2 sites, 2 recruiting
  • Rijnstate

    Arnhem, Gelderland

    Recruiting
  • Radboudumc

    Nijmegen, Gelderland

    Laurien M Buffart, PhD, +31 24 3667310, laurien.buffart@radboudumc.nl

    Recruiting

Other trials in Netherlands

About this study

The primary aim of this study is to evaluate the feasibility of a supervised high intensity interval training (HIIT) program during first-line dual immune checkpoint inhibitor (ICI) therapy (nivolumab plus ipilimumab) in patients with advanced renal cell carcinoma (RCC). The second aim is to generate preliminary data on the effects of exercise on the immune cell phenotype and function, gut microbiota composition, physical fitness, patient-reported outcomes and clinical outcomes.

This is a two-arm randomized controlled pilot trial in which 30 patients with advanced RCC scheduled to receive first-line nivolumab plus ipilimumab will be randomized in 1:1 ratio to an exercise intervention group or usual care group. The exercise intervention consists of two 60-minute supervised HIIT sessions per week, delivered by oncology-trained physiotherapists and one additional home-based moderate-intensity aerobic exercise sessions per week. The intervention starts with the first cycle of immunotherapy and continues for four treatment cycles. Participants in both groups will receive usual care and general exercise guidelines. Measurements include blood and stool sampling for microbiome and immune parameters analysis, physical fitness assessments, physical fitness monitoring, body composition measurements, and patient-reported outcomes related to quality of life, fatigue, depression, sleep and diet.

Read the detailed description

There is strong evidence from randomized controlled trials that exercise during cancer treatment can maintain physical fitness, limit fatigue, and enhance health-related quality of life (HRQoL). Some studies also showed that exercise may help patients to better tolerate their treatment. However, most exercise trials have been conducted in patients receiving chemotherapy or radiotherapy, and little is known about the feasibility or effects of exercise during immunotherapy, particularly in patients with advanced RCC.

First-line treatment for patients with advanced RCC often consists of dual ICI treatment with nivolumab plus ipilimumab. While this combination has shown to improve survival, a substantial proportion of patients do not respond, and approximately 44% experience any grade immune-related adverse events. Tumor hypoxia, an immunosuppressive tumor microenvironment, and insufficient infiltration of cytotoxic immune cells are key factors believed to contribute to treatment resistance.

Preclinical studies in mice have shown that aerobic exercise can positively influence the tumor microenvironment through reduced tumor hypoxia, enhanced tumor perfusion, and increased activity and infiltration of cytotoxic immune cells such as CD8+ T cells and natural killer (NK) cells, while reducing immunosuppressive cell populations. In addition, preclinical studies in mice suggested that exercise-induced changes in the gut microbiome can further support immune activation and improve responses to immunotherapy. Despite this promising biological rationale, no clinical studies have evaluated whether supervised exercise is feasible or beneficial in patients with advanced RCC.

The primary objective of this pilot randomized controlled trial is to evaluate the feasibility of a supervised exercise program during first-line dual ICI therapy in patients with advanced RCC. Secondary objectives are to explore the preliminary effects of exercise on immune phenotype and function, inflammatory markers, circulating tumor (ct)DNA, gut microbiome composition, body composition, aerobic fitness, muscle function, physical activity, and patient reported outcomes including HRQoL, fatigue, anxiety, depression, sleep, and diet. In addition, changes in immune function, gut microbiome composition and clinical outcomes will also be explored.

This study is a two-arm randomized controlled trial including 30 adult patients with advanced RCC. Participants will be randomized to the intervention arm that receives a supervised HIIT program in addition to usual care or to a usual care control arm. The intervention consists of two supervised 60-minute HIIT-exercise sessions per week, delivered by oncology trained physiotherapists, combined with one additional home-based moderate intensity exercise session of at least 30 min per week. The intervention starts with the first cycle of immunotherapy and continues for four treatment cycles. Blood and stool samples will be collected at baseline and at 6 weeks and 12 weeks during treatment to assess immune and microbiome changes. In addition, in participants allocated to the exercise intervention group, to evaluate the acute effects of exercise on the immune response, blood samples will be collected immediately before and after a supervised exercise session.

Physical fitness tests, questionnaires and Fitbit to monitor physical activity will be used to evaluate functional and patient-reported outcomes.

This pilot study will provide important information on the feasibility of exercise during immunotherapy and generate preliminary data on potential immunological effects. These findings will inform the design of future larger trials aimed to optimize supportive care and improve treatment outcomes for patients with advanced RCC.

Conditions
Oncology
Being tested
HIIT
Keywords
Oncology, Exercise, immunotherapy, Renal cell carcinoma, immune-related adverse events, randomized controlled trial, immune function
Medical subject headings
Neoplasms, Motor Activity, Carcinoma, Renal Cell

What participants receive

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

  • HIITBehavioural

    The intervention group will be offered a supervised exercise program consisting of two 60-minute sessions per week, including continuous aerobic exercise and HIIT. Sessions will be supervised by physiotherapists specialized in oncology, and the training load will be tailored to a patient's individual fitness levels throughout the intervention. Following a short warm-up, participants will perform repeated high-intensity cycling intervals targeting 85-95% of their estimated peak heart rate corresponding to a Borg Rating of Perceived Exertion (RPE) 16-18), interspersed with periods of active recovery at light intensity. The HIIT component will be followed by moderate-intensity aerobic exercise at approximately 70% of the estimated heart rate (Borg RPE 13-14), and a cool-down period. In addition, participants will be asked to be physically active for at least 30 minutes at moderate intensity, in accordance with the American College of Sports Medicine (ACSM) guidelines.

Study groups in NCT07680556
Study groupRoleWhat they receive
High Intensity Interval Training (HIIT)ExperimentalHigh intensity aerobic interval training during dual immunotherapy
Receives: Behavioral: HIIT
Usual care control (UC)No interventionThe control group will receive usual care and will be receive a folder about physical activity recommendations.

What is being measured

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

  1. Participation rate

    Calculated by the proportion of eligible patients that participate. An accrual rate lower than 20% will be defined as not feasible.

    Measured: Study enrolment period (approximately 24 months)

  2. Exercise intervention adherence

    Adherence will be assesed by attendance and exercise relative dose intensity (ExRDI). Attendence will be assessed by dividing the number of attended sessions by the number of prescribed sessions. ExRDI will be calculated as the percentage of the exercise intensity achieved during the performed sessions relative to the total prescribed exercise intensity expressed as a percentage. The information will be collected using questionnaires and exercise-logs registered by the physical therapists. These logs will be collected by the researcher

    Measured: 12 weeks (during intervention period)

  3. Immune-related and exercise-related adverse events

    Immune related adverse events will be assessed using Common Terminology Criteria for Adverse Events (CTCAE) v5.0 based on medical records and the patient reported outcomes (PRO)-CTCAE completed by patients before each immunotherapy cycle and at 3-month follow up.

    Measured: 24 weeks (during intervention period of 12 weeks, and 12 weeks post intervention)

Secondary outcomes (12)
  1. Body composition

    Bioelectrical Impedance Analysis (BIA), Length (cm), Body weight (kg), Muscle mass (kg), Body fat percentage (%). Weight and height will be combined to report BMI in kg/m²

    Measured: 12 weeks (Baseline, post-intervention)

  2. Estimated aerobic fitness

    Steep ramp test

    Measured: 12 weeks (Baseline, post-intervention)

  3. Lower body muscle function

    Lower body muscle function will be assessed using a sit-to-stand test

    Measured: 12 weeks (Baseline, post-intervention)

  4. Physical activity

    Modified Godin Leisure-Time Exercise Questionnaire, Fitbit continuously

    Measured: 12 weeks (Baseline, post-intervention)

  5. Health-related quality of life (HRQoL)

    European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaire

    Measured: 12 weeks (Baseline, post-intervention)

  6. Fatigue

    European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Fatigue Module (EORTC QLQ FA12) questionnaire

    Measured: 12 weeks (Baseline, post-intervention)

  7. Anxiety and depression

    Hospital Anxiety and Depression Scale (HADS) questionnaire

    Measured: 12 weeks (Baseline, post-intervention)

  8. Sleep

    Pittsburgh Sleep Quality Index (PSQI) questionnaire

    Measured: 12 weeks (Baseline, post-intervention)

  9. Diet

    World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations Questionnaire

    Measured: 12 weeks (Baseline, post-intervention)

  10. ctDNA

    Venous blood sampling, concetration ctDNA (ng/mL) next-generation sequencing

    Measured: 12 weeks (baseline, 6 weeks, and post-intervention)

  11. Immune cell phenotype and function, and inflammatory markers

    Venous blood sampling and flow cytometry to determine frequency (%) of circulating immune cells, functional characteristics of circulating immune cells will be determined using functional assays, inflammatory marker concentrations will measured (pg/mL or ng/mL).

    Measured: 12 weeks (baseline, 6 weeks, and post-intervention)

  12. Gut microbiome composition

    Taxonomic features and alpha and beta diversity via 16S rRNA marker gene sequencing of feces samples

    Measured: 12 weeks (baseline and post-intervention)

Timeline

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

  1. First posted2 Jul 2026
  2. Study start22 Jul 2026
  3. Primary completion1 Jul 2028 (estimated)
  4. Study completion1 Sep 2028 (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
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07680556
Sponsor's protocol ID
NL-011443
Other IDs
NL-011443
Acronym
PRIMER
Status last verified
Jun 2026
First submitted
17 Jun 2026
Last updated
28 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: IPD will be shared via the POLARIS consortium see PROSPERO registry CRD42013003805 or paper: Buffart et al. Systematic Reviews 2013; 2: 75.

Questions about this trial

What is this clinical trial studying?

A study testing HIIT in people with Oncology, run by Radboud University Medical Center at 2 sites in Netherlands.

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 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: looking for participants now, as of the sponsor's last update on 28 Aug 2026. 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 Netherlands. 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 Laurien Buffart, PhD (+31 24 3667310, laurien.buffart@radboudumc.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Participation rate (time frame: Study enrolment period (approximately 24 months)). The study lists 3 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 28 Aug 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in