- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02950324
Does Prehabilitation Improve Exercise Performance and Insulin Resistance After Surgery for Oesophago-gastric Cancer?
Does Prehabilitation Improve Performance in Cardiopulmonary Exercise Testing and Reduce Insulin Resistance in Patients Undergoing Neo-adjuvant Treatment and Surgery for Oesophago-gastric Cancer?
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The trial objectives are as follows: Primary: To evaluate the effect of a prehabilitation programme during neo-adjuvant therapy on CPX performance prior to resection for oesophago-gastric cancer. Secondary: To investigate the impact of neo-adjuvant chemotherapy on insulin resistance; to determine whether a prehabilitation exercise programme is feasible during neo-adjuvant chemotherapy; to determine whether rehabilitation has a positive impact on quality of life outcomes; to investigate the impact of prehabilitation on clinical outcomes; to assess the effect of prehabilitation on nutritional status; to determine whether prehabilitation affects the stress response to surgery.
This study is a randomised controlled trial where patients will be stratified into 'fit' and 'unfit' groups based upon their anaerobic threshold and then randomised in a 1:1 ratio to receive multimodal prehabilitation or standard care prior to OG cancer surgery, during neo-adjuvant chemotherapy.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Guildford, United Kingdom, GU2 7XX
- Royal Surrey County Hospital NHS Foundation Trust
-
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients listed for elective oesophagectomy or total gastrectomy for cancer
- Must have capacity to consent
- Age 18-99
Exclusion Criteria:
- Known contraindication for CPX
- Physically unable to perform CPX test or undertake prehabilitation exercise programme
- Pregnant patients or those planning to become pregnant
- Lack of capacity to give informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Prehabilitation
Patients in this (intervention) arm of the study will be enrolled into a multimodal programme that involves 15 weeks of exercise, nutritional support and psychological prehabilitation in the form of 'Medical Coaching'.
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Patients in the intervention, 'Prehabilitation', arm of the study will be enrolled into a multimodal programme that involves 15 weeks of exercise, nutritional support and psychological prehabilitation in the form of 'Medical Coaching'.
This will take place during neo-adjuvant treatment prior to oesophagectomy or gastrectomy for cancer.
|
|
Active Comparator: Standard care
Patients in the 'standard care' arm of the study will not receive the study intervention.
The patients will continue to be offered the standard dietetic and psychological support as per the enhanced recovery pathway and current standard of care.
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Patients in the 'standard care' arm of the study will not receive the study intervention.
The patients will continue to be offered theatients in this arm of the study will not receive the study intervention.
The patients will continue to be offered the standard dietetic and psychological support as per the enhanced recovery pathway and current standard of care standard dietetic and psychological support as per the enhanced recovery pathway and current standard of care.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Change in cardiopulmonary exercise performance
Time Frame: Change in cardiopulmonary exercise performance between week 0 and week 17
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Change in cardiopulmonary exercise performance between week 0 and week 17
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Change in insulin resistance
Time Frame: Change in insulin resistance between week 0 and week 17
|
Change in insulin resistance between week 0 and week 17
|
|
Change in quality of life
Time Frame: Change in quality of life (as assessed by the EORTC QLQ C30 questionnaire) between week 0 and 6 months
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Change in quality of life (as assessed by the EORTC QLQ C30 questionnaire) between week 0 and 6 months
|
|
Change in grip-strength
Time Frame: Change in grip-strength between 0 weeks and 6 months
|
Change in grip-strength between 0 weeks and 6 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Sophie Allen, MBBCh, Royal Surrey County Hospital NHS Trust
Publications and helpful links
General Publications
- Allen SK, Brown V, White D, King D, Hunt J, Wainwright J, Emery A, Hodge E, Kehinde A, Prabhu P, Rockall TA, Preston SR, Sultan J. Multimodal Prehabilitation During Neoadjuvant Therapy Prior to Esophagogastric Cancer Resection: Effect on Cardiopulmonary Exercise Test Performance, Muscle Mass and Quality of Life-A Pilot Randomized Clinical Trial. Ann Surg Oncol. 2022 Mar;29(3):1839-1850. doi: 10.1245/s10434-021-11002-0. Epub 2021 Nov 1.
- Allen S, Brown V, Prabhu P, Scott M, Rockall T, Preston S, Sultan J. A randomised controlled trial to assess whether prehabilitation improves fitness in patients undergoing neoadjuvant treatment prior to oesophagogastric cancer surgery: study protocol. BMJ Open. 2018 Dec 22;8(12):e023190. doi: 10.1136/bmjopen-2018-023190.
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16/LO/1702
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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