- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03659123
Prehabilitation & Rehabilitation in Oncogeriatrics: Adaptation to Deconditioning Risk and Accompaniment of Patients' With Cancer (PROADAPT)
Prehabilitation & Rehabilitation in Oncogeriatrics: Adaptation to Deconditioning Risk and Accompaniment of Patients' With Cancer, a Multicenter Pilot Study
With the conjunction of increased life expectancy and the increasing incidence of cancer with aging, older patient represent an increasing proportion of cancer patients. Increasing age is also associated with increased risk of co-morbidities as well as a decline of functional reserve of multiple organ systems, eventually leading in the context of the disease-and/or the treatment-related stress to functional deconditioning or organ failure.
Surgery or complex medico-surgical procedures - that associate chemotherapy and/or radiotherapy and surgery, can be considered as one proof-of principle of such risks, since major cancer surgery the older population is at higher risk of morbi-mortality and unplanned hospitalization for geriatric events In order to reduce complications after surgery, prehabilitation has often been considered, and 71% of the surgeons would accept a 4 weeks delay before surgery to improve patients' outcomes if shown to be beneficial. However, the actual level of evidence depends on the interventions: high for pre-operative nutrition, but low for physical exercise, due to heterogeneous programs with often bad adherence. In addition, geriatric validated interventions, in order to prevent iatrogenic event, may be added in a multi-interventional model of intervention.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
PROADAPT pilot study is a standardized geriatric intervention constructed on a multi-professional and multi-disciplinary basis after a systematic analysis of published data.
This intervention was designed to be implemented pragmatically in the centers according local habits in several distinct hospital contexts in different tumor contexts.
It consists in:
- before surgery: a prehabilitation of the patients including a nutritional, physical and educational preparation;
- during the hospitalization for surgery: an optimisation of their treatments through a pharmaceutical conciliation, educational interventions, standardization of surgical procedures and enhanced rehabilitation after surgery;
- bridging and post-discharge interventions for hospital-to-home transition.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Chambéry, France
- Centre Hospitalier de Chambéry
-
Givors, France
- Centre hospitalier de Givors
-
Lyon, France
- Hopital Croix Rousse
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Lyon, France
- Centre Hospitalier Edouard Herriot
-
Metz-Tessy, France
- Centre Hospitalier d'Annecy Genevois
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Pierre-Bénite, France
- Centre Hospitalier Lyon Sud, Service d'Oncologie Médicale
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Pierre-Bénite, France
- Centre Hospitalier Lyon Sud, Service de Gériatrie
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Saint-Étienne, France
- Centre Hospitalier Universitaire de Saint Etienne
-
Villefranche-sur-Saône, France
- Hôpital Nord-Ouest
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Villeurbanne, France
- Clinique mutualiste Médipole
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient ≥70 year old OR patient ≥60 years with significant comorbid condition (modified Charlson index≥3) or disability (ADL score<6/6);
- Histologically or cytologically proven cancer.
- Life expectancy > 3 months.
- Written informed consent obtained
- Covered by a Health System where applicable.
Exclusion Criteria:
- Other malignancy within the last 5 years, except for adequately treated carcinoma in situ of the cervix or squamous carcinoma of the skin, or adequately controlled limited basal cell skin cancer.
- Patient unable to be regularly followed for any reason (geographic, familial, social, psychologic).
- Any mental or physical handicap at risk of interfering with the appropriate treatment.
- Any administrative or legal supervision where applicable
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention
The intervention is designed to be implemented at different times of patients' care During the prehabilitation time:
|
Nutritional care is based on:
Total-body rehabilitation is based on:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Implementation of at least one item of PROADAPT standardized geriatric intervention of the program PROADAPT pilot study
Time Frame: 12 months
|
Preoperative physical activity including strength and endurance exercise assessed by physical exercises accomplished under the supervision of a physiotherapist.
Number of patients with at least 1 intervention achieved in the domain.
|
12 months
|
Implementation of at least one item of PROADAPT standardized geriatric intervention of the program PROADAPT pilot study
Time Frame: 12 months
|
Nutrition guidelines before and after physical activity assessed by questionnaires.
Number of patients with at least 1 intervention achieved in the domain.
|
12 months
|
Implementation of at least one item of PROADAPT standardized geriatric intervention of the program PROADAPT pilot study
Time Frame: 12 months
|
Patient education and coaching assessed by questionnaires and visits.
Number of patients with at least 1 intervention achieved in the domain
|
12 months
|
Implementation of at least one item of PROADAPT standardized geriatric intervention of the program PROADAPT pilot study
Time Frame: 12 months
|
Achievement of standardized intervention procedures, according to the checklist established in consensus with surgeons.
Number of patients with at least 1 intervention achieved in the domain
|
12 months
|
Implementation of at least one item of PROADAPT standardized geriatric intervention of the program PROADAPT pilot study
Time Frame: 12 months
|
Rehabilitation assessed by questionnaires.
Number of patients with at least 1 intervention achieved in the domain
|
12 months
|
Implementation of at least one item of PROADAPT standardized geriatric intervention of the program PROADAPT pilot study
Time Frame: 12 months
|
Accomplishment of pharmaceutical medication conciliation and treatment optimization.
Number of patients with at least 1 intervention achieved in the domain
|
12 months
|
Implementation of at least one item of PROADAPT standardized geriatric intervention of the program PROADAPT pilot study
Time Frame: 12 months
|
Bridging interventions for hospital-to-home transition.
Number of patients with at least 1 intervention achieved in the domain
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression-free Survival
Time Frame: 12 months
|
12 months
|
|
Post operative morbidity
Time Frame: 30 and 90 days
|
Post operative morbidity according Clavien-Dindo classification
|
30 and 90 days
|
Post-operative morbidity
Time Frame: 90 days
|
Post-operative morbidity according to NCI CTC v4.4
|
90 days
|
Therapeutic strategy
Time Frame: 12 months
|
Treatment plan completion rate: Number of patients for whom the treatment plan was completed.
|
12 months
|
Post-treatment complication
Time Frame: 12 months
|
Post-treatment complication grade≥3 according the National Cancer Institute Common Toxicity Criteria version 4 (NCI-CTC-v4)
|
12 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Claire FALANDRY, MD, Hospices Civils de Lyon
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- 69HCL16_0701
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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