- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02489422
Programs To Support You During Chemotherapy (PRO-YOU)
GI 1549: PROGRAMS TO SUPPORT YOU DURING CHEMOTHERAPY (PRO-YOU) A Randomized Controlled Pilot Study of Yoga Compared to an Attention Control in Patients Receiving Chemotherapy
Study Overview
Status
Conditions
- Depression
- Stomach Cancer
- Fatigue
- Pancreatic Cancer
- Esophageal Cancer
- Small Intestine Cancer
- Anal Cancer
- Liver Cancer
- Biliary Tract Cancer
- Gallbladder Cancer
- Appendix Cancer
- Stage IVA Colorectal Cancer
- Stage IVB Colorectal Cancer
- Stage IIIA Colorectal Cancer
- Stage IIIB Colorectal Cancer
- Stage IIIC Colorectal Cancer
- Large Intestine Cancer
- Stage IIA Colorectal Cancer
- Stage IIB Colorectal Cancer
- Stage IIC Colorectal Cancer
- Gastrointestinal Stromal Cancer
Detailed Description
PRIMARY OBJECTIVES:
I. To conduct a pilot randomized controlled trial of the yoga skills training (YST) versus a caring attention control (AC) group among adults with colorectal cancer (CRC) receiving chemotherapy to determine preliminary efficacy for the primary outcome of fatigue, secondary outcome of depressive symptoms, and possible mediators (i.e., psychological stress, circadian disruption, inflammation) as assessed by standard measures.
SECONDARY OBJECTIVES:
I. To measure the impact of the YST versus the AC on daily assessments of fatigue, depressive symptoms, and proposed mediators in the same trial and explore relationships among daily and standard assessments.
II. To qualitatively assess perceived efficacy of the YST and AC and acceptability of new methodology through semi-structured interviews in a subset of 20-40 participants.
OUTLINE: Patients are randomized to 1 of 2 groups.
GROUP I (YST): Patients participate in YST consisting of four 30 minute in-person yoga sessions at weeks 2, 4, 6, and 8 that instructs skills to enhance mindfulness and promote relaxation, through instruction of awareness, movement, breathing practices, and meditation.
GROUP II (AC): Patients participate in four 30 minute in-person sessions of supportive conversation at weeks 2, 4, 6, and 8.
After completion of study, patients are followed up at 4 weeks.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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North Carolina
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Winston-Salem, North Carolina, United States, 27157
- Wake Forest Baptist Comprehensive Cancer Center
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Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt University/Ingram Cancer Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Scheduled to receive first-line Fluorouracil (5FU)-based intravenous chemotherapy treatment for a gastrointestinal cancer (stages II-IV)
- Have an Eastern Cooperative Oncology Group performance status of =< 1
- Ability to understand and the willingness to sign and informed consent document in English
Exclusion Criteria:
- Has a self-reported history of diagnosed uncontrolled obstructive sleep apnea (ok if using CPAP), sleep-related seizures, sleep walking more than one time per week, restless leg syndrome, or a job with night shifts
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Group I (Yoga Skills Training)
Patients participate in YST consisting of four 30 minute in-person yoga sessions at weeks 2, 4, 6, and 8 that instructs skills to enhance mindfulness and promote relaxation, through instruction of awareness, movement, breathing practices, and meditation.
|
Correlative studies
Ancillary studies
Ancillary studies
The YST intervention consists of four 30 minute in-person sessions that instructs skills to enhance mindfulness and promote relaxation.
Participants will also be encouraged to practice daily at home.
Other Names:
Ancillary studies
Other Names:
|
Active Comparator: Group II (Attention Control)
Patients participate in four 30 minute in-person sessions of supportive conversation at weeks 2, 4, 6, 8.
|
Correlative studies
Ancillary studies
Ancillary studies
Ancillary studies
Other Names:
The AC intervention consists of four 30 minute in-person sessions of supportive conversation.
In addition, the interventionist will recommend that the patients write brief diary entries daily at home.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Fatigue Assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS)
Time Frame: At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
|
Fatigue will be assessed with the 7-item measure of Fatigue from the PROMIS-cancer specifically designed for use in cancer patients.
These tests will be evaluated using mixed-effects (or multilevel) generalized linear modeling procedures.
Score range 1 - never, 2 - rarely, 3 - sometimes, 4 - often and 5 - always.
Total scores can range from 24 to 86, with higher scores indicating greater fatigue.
|
At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Circadian Disruption (Daily)
Time Frame: At 0-2 weeks after start of intervention
|
Circadian disruption will be assessed with actigraphy.
Circadian disruption is defined as a ratio of nighttime activity to daytime activity with higher scores indicating greater circadian disruptions.
Summaries of the proportion and frequency of missing daily assessments will inform the feasibility of collecting this type of data.
|
At 0-2 weeks after start of intervention
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Circadian Disruption (Daily)
Time Frame: At 8-10 weeks after start of intervention
|
Circadian disruption will be assessed with actigraphy.
Circadian disruption is defined as a ratio of nighttime activity to daytime activity with higher scores indicating greater circadian disruptions.
Summaries of the proportion and frequency of missing daily assessments will inform the feasibility of collecting this type of data.
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At 8-10 weeks after start of intervention
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Circadian Disruption (Recalled)
Time Frame: At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
|
Circadian disruption will be assessed with measures of activity and rest.
Activity will be measured using the 3-item Godin's leisure score index (LSI), previously used with colorectal cancer patients during chemotherapy.
Rest will be assessed with the 8-item PROMIS sleep disturbance short-form.
Each item on the measure is rated on a 5-point scale (1=never; 2=rarely; 3=sometimes; 4=often; and 5=always) with a range in score from 8 to 40 with higher scores indicating greater severity of sleep disturbance.
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At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Depressive Symptoms Assessed by PROMIS
Time Frame: At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
|
Will be assessed with the standardized 10-item PROMIS-cancer depressive symptoms short-form.
These tests will be evaluated using mixed-effects (or multilevel) generalized linear modeling procedures.
Scoring scale range from 1 - never, 2 - rarely, 3 - sometimes, 4 - often and 5 - always.
The higher the score the more depressive the symptoms.
Scores on the short form range from 10 to 81.3; 10-55 is "normal", 55.1-59.9
"mild", 60-64.25 "moderate", and over 64.26 "severe" depression.
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At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Fatigue (Daily)
Time Frame: At 0-2 weeks and 8-10 weeks after start of intervention
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Fatigue will be assessed with 3 items selected from the PROMIS measure of fatigue validated for use in daily diaries.
Scoring scale range from 1 - never, 2 - rarely, 3 - sometimes, 4 - often and 5 - always.
The higher the score the more fatigued the participants.
Scores on the short form range from 0 to 81.3; 0-55 is "normal", 55.1-59.9
"mild", 60-64.25 "moderate", and over 64.26 "severe" fatigue.
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At 0-2 weeks and 8-10 weeks after start of intervention
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Depressive Symptoms (Daily)
Time Frame: At 0-2 weeks and 8-10 weeks after start of intervention
|
Depressive symptoms will be assessed with 3 items selected from the PROMIS measure of depression validated for use in daily diaries.
Scoring scale range from 1 - never, 2 - rarely, 3 - sometimes, 4 - often and 5 - always.
The higher the score the more depressive symptoms the participants exhibited.
scores on the short form range from 0 to 81.3; 0-55 is "normal", 55.1-59.9
"mild", 60-64.25 "moderate", and over 64.26 "severe" depression.
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At 0-2 weeks and 8-10 weeks after start of intervention
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Interleukin 6 [IL-6] Measured Using High-sensitivity Quantikine Immunoassay Kits
Time Frame: At 2 weeks after start of intervention
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Inflammatory cytokines (i.e., interleukin 6 [IL-6], soluble tumor necrosis factor receptor 1 [sTNF-R1], and tumor necrosis factor alpha [TNF-alpha]) that have been associated with fatigue during treatment for gastrointestinal cancer and influenced by yoga practice will be measured using high-sensitivity Quantikine immunoassay kits.
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At 2 weeks after start of intervention
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Interleukin 6 [IL-6] Measured Using High-sensitivity Quantikine Immunoassay Kits
Time Frame: At 10 weeks after start of intervention
|
Inflammatory cytokines (i.e., interleukin 6 [IL-6], soluble tumor necrosis factor receptor 1 [sTNF-R1], and tumor necrosis factor alpha [TNF-alpha]) that have been associated with fatigue during treatment for gastrointestinal cancer and influenced by yoga practice will be measured using high-sensitivity Quantikine immunoassay kits.
).
All samples will be assayed in duplicate and the average of the two measures will be used for data analyses.
|
At 10 weeks after start of intervention
|
Soluble Tumor Necrosis Factor Receptor 1 [sTNF-R1] Measured Using High-sensitivity Quantikine Immunoassay Kits
Time Frame: At 2 weeks after start of intervention
|
Inflammatory cytokines (i.e., interleukin 6 [IL-6], soluble tumor necrosis factor receptor 1 [sTNF-R1], and tumor necrosis factor alpha [TNF-alpha]) that have been associated with fatigue during treatment for gastrointestinal cancer and influenced by yoga practice will be measured using high-sensitivity Quantikine immunoassay kits.
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At 2 weeks after start of intervention
|
Soluble Tumor Necrosis Factor Receptor 1 [sTNF-R1] Measured Using High-sensitivity Quantikine Immunoassay Kits
Time Frame: At 10 weeks after start of intervention
|
Inflammatory cytokines (i.e., interleukin 6 [IL-6], soluble tumor necrosis factor receptor 1 [sTNF-R1], and tumor necrosis factor alpha [TNF-alpha]) that have been associated with fatigue during treatment for gastrointestinal cancer and influenced by yoga practice will be measured using high-sensitivity Quantikine immunoassay kits.
All samples will be assayed in duplicate and the average of the two measures will be used for data analyses.
|
At 10 weeks after start of intervention
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Tumor Necrosis Factor Alpha [TNF-alpha] Measured Using High-sensitivity Quantikine Immunoassay Kits
Time Frame: At 2 weeks after start of intervention
|
Inflammatory cytokines (i.e., interleukin 6 [IL-6], soluble tumor necrosis factor receptor 1 [sTNF-R1], and tumor necrosis factor alpha [TNF-alpha]) that have been associated with fatigue during treatment for gastrointestinal cancer and influenced by yoga practice will be measured using high-sensitivity Quantikine immunoassay kits.
|
At 2 weeks after start of intervention
|
Tumor Necrosis Factor Alpha [TNF-alpha] Measured Using High-sensitivity Quantikine Immunoassay Kits
Time Frame: At 10 weeks after start of intervention
|
Inflammatory cytokines (i.e., interleukin 6 [IL-6], soluble tumor necrosis factor receptor 1 [sTNF-R1], and tumor necrosis factor alpha [TNF-alpha]) that have been associated with fatigue during treatment for gastrointestinal cancer and influenced by yoga practice will be measured using high-sensitivity Quantikine immunoassay kits.
All samples will be assayed in duplicate and the average of the two measures will be used for data analyses.
|
At 10 weeks after start of intervention
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Psychological Stress Assessed by the Perceived Stress Scale (PSS)
Time Frame: At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Psychological stress will be assessed by the 10-item PSS.
The PSS has 2 factors (stress and counter stress).
Scoring scale range from 0 - never, 1 - almost never, 2 - sometimes, 3 - fairly often and 4 - very often.
Score range is 0-40.
A higher score represents more of the concept being measured.
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At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Psychological Stress Assessed by the PSS (Daily)
Time Frame: At 0-2 weeks and 8-10 weeks after start of intervention
|
Psychological stress will be assessed daily with two items from the 4-item PSS that would be on the same factor to optimize internal consistency.
Scoring scale range from 1 - never, 2 - rarely, 3 - sometimes, 4 - often and 5 - always.
A mean of the participants scores was taken.
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At 0-2 weeks and 8-10 weeks after start of intervention
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Regulation of Psychological Stress Assessed by the Positive and Negative Affect Schedule-Expanded Form (Daily)
Time Frame: At 0-2 weeks and 8-10 weeks after start of intervention
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Regulation of psychological stress will be assessed daily with the 3-item serenity subscale (calm, relaxed, at ease) from the Positive and Negative Affect Schedule-Expanded Form.
Each item is rated on a five-point Likert Scale, ranging from 1 = Very Slightly or Not at all to 5 = Extremely.
Positive Affect Score: Scores can range from 10 - 50, with higher scores representing higher levels of positive affect and lower scores representing lower levels of negative affect.
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At 0-2 weeks and 8-10 weeks after start of intervention
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Regulation of Psychological Stress Assessed Using the Cancer Behavior Inventory
Time Frame: At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Regulation of psychological stress will be determined by ratings on four of the seven factors of the Cancer Behavior Inventory, which assess self-efficacy for stress management, coping with treatment-related side-effects, accepting cancer/maintaining positive attitude, and affective regulation.
Scale ranged from 1-9 (1 - 3 not at all confident; 4-6 moderately confident and 7-9 totally confident).
4 of the 7 items from the Cancer Behavior Inventory (V2.0) were used with each item's score ranges from 0-50 with higher scores indicating more confidence in the item.
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At baseline, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Minutes of Home Practice Completed
Time Frame: Up 10 weeks after start of intervention
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Participants will keep daily paper logs of their home practice.
In addition, one item will ask via the daily automated survey how many minutes participants practiced the intervention that day for two weeks after completion of the intervention.
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Up 10 weeks after start of intervention
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Percent of Planned In Person Intervention Sessions Attended
Time Frame: At baseline, 2 weeks, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Percent of all assessments completed and timeliness of completion will be tracked.
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At baseline, 2 weeks, 8 weeks, 10 weeks and 14 weeks after start of intervention
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Number of Participants With Successful Qualitative Data Collection
Time Frame: At 14 weeks after start of intervention
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Qualitative feedback will be assessed with a semi-structured interview conducted after completion of all assessments.
Qualitative information gained will enrich quantitative results and inform the protocol of a larger trial.
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At 14 weeks after start of intervention
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Stephanie Sohl, MD, Vanderbilt University/Ingram Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Neoplasms by Site
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Stomach Diseases
- Colonic Diseases
- Intestinal Diseases
- Rectal Diseases
- Gallbladder Diseases
- Biliary Tract Diseases
- Cecal Diseases
- Rectal Neoplasms
- Anus Diseases
- Cecal Neoplasms
- Stomach Neoplasms
- Colorectal Neoplasms
- Intestinal Neoplasms
- Anus Neoplasms
- Biliary Tract Neoplasms
- Gallbladder Neoplasms
- Appendiceal Neoplasms
Other Study ID Numbers
- IRB00038321
- P30CA068485 (U.S. NIH Grant/Contract)
- NCI-2015-01042 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- CCCWFU 01716 (Other Identifier: Comprehensive Cancer Center of Wake Forest University)
- K01AT008219 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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