CAREFOR: Precision Medicine Driving Precision Nutrition for the Treatment of NeoAdjuvant Breast Cancer
CAREFOR Study: Precision Nutrition Caloric Restriction for Oncology Research: Precision Medicine Driving Precision Nutrition During Neoadjuvant Chemotherapy for Breast Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Primary objective:
I To determine if dietary alternations designed to downregulate the dominate molecular drivers of an individuals' breast cancer will enhance the effect of neoadjuvant chemotherapy and allow for an increase in the pathologic complete response rate.
Secondary objectives
I) Investigator measurable changes to molecular and patient characteristics from precision nutrition to determine a metric for evaluation this treatment in future studies.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Pennsylvania
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Philadelphia, Pennsylvania, United States, 19107
- Sidney Kimmel Cancer Center at Thomas Jefferson Univeristy
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Pathologically proven invasive breast cancer
- Planned neoadjuvant chemotherapy determined by the judgment of the medical oncologist
- The patient must be female
- Age ≥ 18
- Non-metastatic and non-inflammatory breast cancer
- History/physical examination, including breast exam and documentation of weight and Karnofsky Performance Status of 80-100% for at least 60 days prior to study entry.
- Women of childbearing potential must be non-pregnant and non-lactating and willing to use medically acceptable form of contraception during chemotherapy
- Patient must capable of and provide study specific informed consent prior to study entry
- BMI ≥21
- Weight ≥120lbs
- No prior history of non-breast malignancies in the past 1 year unless it was a non- melanomatous skin lesion or carcinoma in situ of the cervix.
- Patient must not have Acquired Immune Deficiency Syndrome (AIDS) or HIV positive based upon current CDC definition; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS or HIV from this protocol is necessary because anti-retrovirals may alter patient metabolism.
- Patient may not have any active Gastrointestinal/Malabsorption disorder at the discretion of the Principal Investigator which may include:
- Chronic Pancreatitis
- Chronic Diarrhea or Vomiting
- Active Eating Disorder
- No history of or current active drug/alcohol dependence.
- No patients with decisional impairment.
Exclusion Criteria:
- Patient is male.
- Age <18 years
- Clinical stage IV cancer
- Inflammatory breast cancer (T4d)
- Women of childbearing potential with a positive serum beta hCG.
- Decision impaired patients.
- BMI < 21
- Weight < 120lbs
- Weight loss ≥10% in the last 3 mos
- Prior invasive non-breast malignancy (except non-melanomatous skin cancer, carcinoma in situ of the cervix) unless disease free for a minimum of 1 year prior to registration
- Non-epithelial breast malignancies such as sarcoma or lymphoma
Active Gastrointestinal/Malabsorption disorder at the discretion of the Principal -Investigator which may include:
- Chronic Diarrhea or Vomiting
- Active Eating Disorder
- Active drug/alcohol dependence or abuse history.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Precision Nutrition (dietary intervention)
During chemotherapy, patients will receive dietary counseling based on the molecular pathways driving their specific breast cancers found through genetic testing.
Nutritional recommendations will seek to down-regulate the dominant molecular drivers of an individual's breast cancer while they are receiving standard chemotherapy as outlined by their treating medical oncologist.
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Receive dietary counseling
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pathologic complete response assessed in tissue
Time Frame: At time of definitive breast surgery
|
The portion of patients who adhere to the diet restriction will be computed along with a 95% exact confidence.
An exact binomial test (with a onesided alpha of 0.05) will also be used to test whether adherence is greater than 60%.
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At time of definitive breast surgery
|
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Incidence of adverse events evaluated by CTCAE version 4.0
Time Frame: Up to 24 months
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Up to 24 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of study participants who receive the dietary intervention to the historical controls
Time Frame: Up to 24 months
|
Will be compared to historical controls.
Will be based on logistic regression, which will control for patient characteristics and clinical factors.
The study has 81% power to detect an odds ratio of about 0.25 using a 2-sided alpha of 0.05
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Up to 24 months
|
|
Weight changes
Time Frame: Up to 24 months
|
Will be assessed by modeling body mass index as a function of time via mixed-effects regression.
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Up to 24 months
|
|
Change in insulin
Time Frame: Up to 24 months
|
Will be assessed as a function of time via mixed-effects regression.
|
Up to 24 months
|
|
Change in serum
Time Frame: Up to 24 months
|
Will be assessed as a function of time via mixed-effects regression.
|
Up to 24 months
|
|
Distant metastases
Time Frame: Up to 24 months
|
Will be analyzed via the Kaplan-Meier method and the logrank test.
|
Up to 24 months
|
|
Progression-free survival
Time Frame: Up to 24 months
|
Kaplan-Meier curves will be generated and a log-rank value will be calculated.
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Up to 24 months
|
|
Overall survival
Time Frame: Up to 24 months
|
Will be analyzed with the Kaplan-Meier method and Cox proportional hazards regression.
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Up to 24 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Nicole Simone, MD, Thomas Jefferson University
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 16D.067
- JT 8562 (Other Identifier: JeffTrial Number)
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