Acute Exercise Intervention in Breast Cancer Survivors (ACE)

Acute Effects of Exercise on Breast Cancer Biomarkers (ACE) Study

This trial studies how a 45-minute bout of acute exercise in women with a history of breast cancer can affect factors associated with breast cancer and help doctors learn more about how exercise can help prevent breast cancer.

In an earlier part of the study, investigators looked at the effects of the same intervention in women without a history of cancer.

Study Overview

• Status: Terminated
• Conditions: Breast Carcinoma
• Intervention / Treatment: Other: Questionnaire Administration; Other: Biomarker Analysis; Behavioral: Exercise Intervention; Other: Resting

Detailed Description

OUTLINE: Participants are randomized to 1 of 2 arms.

ARM I: Participants undergo a moderate-intensity acute exercise bout over 45 minutes.

ARM II: Participants rest by sitting for 45 minutes.

EXTENSION: After completion of initial study recruitment and data collection, an extension was approved in 2023.

EXTENSION OUTLINE: Participants are randomized to 1 of 2 arms.

EXTENSION ARM I: Participants exercise on a stationary bike for 45 minutes.

EXTENSION ARM II: Participants rest by sitting for 45 minutes.

• Study Type: Interventional
• Enrollment (Actual): 112
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Washington
    • Seattle, Washington, United States, 98109
      • Fred Hutch/University of Washington Cancer Consortium

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Current Inclusion Criteria (for Extension participants):

• Female
• History of Stage 0-IIIc breast cancer, diagnosed within the last 5 years
• Completed primary treatment at least 6 months ago
• Able to attend 2 clinic visits at the Fred Hutch Prevention Center for approximately 2.5 hours at a time
• Aged 36-75 years. Younger women will be excluded because a sizable proportion may remain premenopausal and will resume menstruation within 2 years of chemotherapy completion.
• Postmenopausal (no menstrual periods in the previous 12 months either naturally, or as a consequence of treatment)
• All race and ethnic groups are eligible for the study
• Able to perform all study requirements, including attendance at clinic visits and capable of responding to questionnaires and clinic and exercise facility instructions in English
• Willing to consent to release of medical records for their breast cancer diagnosis and treatment
• If a patient has received a cardiotoxic therapy (e.g., Adriamycin, Herceptin), clearance of their oncologist to participated in this study will be required.

Completed Inclusion Criteria (for participants enrolled prior to Extension portion of study):

• Resident in greater Seattle metropolitan area (King County), Pierce or Snohomish Counties
• Healthy
• Able to perform all study requirements, including attendance at clinic visits and capable of responding to questionnaires and clinic and exercise facility instructions in English
• Willing to be randomized
• Capable of providing informed consent

Current Exclusion Criteria (for Extension participants):

• Family history of breast cancer
• If known, BRCA 1/2 mutation carrier
• If known, Li-Fraumeni Syndrome
• Personal history of cancer other than breast: exceptions are non-melanoma skin cancer and cervical neoplasia (CIN)
• Serious health conditions including diabetes, renal disease (e.g., chronic kidney disease), liver disease (e.g., cirrhosis, chronic liver failure), chronic lung disease (COPD, moderate or severe persistent asthma), auto-immune disease requiring oral or inhaled medication, congestive heart failure, or other condition likely to interfere with ability to exercise at moderate levels and undergo biosampling, or likely to interfere with study outcomes.
• Fasting glucose fingerstick >126 mg/dL
• Taking any medications to treat high blood sugar such as metformin
• Contraindications for exercise testing (29) including: recent (within 6 months) cardiac event (MI, pulmonary edema, myocarditis, pericarditis), unstable angina, uncontrolled arrhythmia, third degree heart block, left bundle branch block, acute congestive failure, recent (within 6 months) pulmonary/systemic embolus, severe electrolyte abnormality, deep vein thrombosis, uncontrolled hypertension (systolic > 200, diastolic > 100), orthostatic hypotension, moderate/severe aortic stenosis, uncontrolled arrhythmia, uncontrolled congestive heart failure, history of cardiac arrest or stroke, or as assessed by the physician assistant during the physical exam.
• History of clotting disorders
• Unable or unwilling to stop aspirin or NSAIDs for 48 hours before and after the procedure
• Allergy to anesthetics or local anesthetics
• Long term use of warfarin or similar medications
• Use of medications that could affect exercise ability, blood biomarkers, or muscle biomarkers, including weight loss medications, statins, oral beta-blockers, performance-enhancing drugs, metformin or other diabetic drug, and oral corticosteroids.
• Use of any sex hormones (estrogen, progesterone, testosterone or other androgens, for the previous 3 months) of any type including oral, creams, vaginal creams or inserts, patches, implants). Participants will be allowed to be on maintenance anti-estrogen therapy - e.g., tamoxifen, aromatase inhibitors
• Consumption of (on average) more than 2 alcoholic drinks per day
• Current use of any tobacco products including smoking, vaping, chew, nicotine patches
• Frequent marijuana use (>1 per month)
• Current participation in another randomized controlled trial

Completed Exclusion Criteria (for participants enrolled prior to Extension portion of study):

• Pregnant in past 3 months
• Lactating
• Premenopausal women: irregular menstrual periods for the previous 6 months; no use of oral contraceptives for the previous 3 months, no use of hormone implants or intrauterine device (IUD) for in the previous year, no use of other sex hormones including testosterone or other androgens for the previous 3 months
• Postmenopausal women: no use of any sex hormones (estrogen, progesterone, testosterone or other androgens, for the previous 3 months) of any type including oral, creams, vaginal creams or inserts, patches, implants
• Current use of any tobacco products including smoking, vaping, chew, nicotine patches
• History of diabetes mellitus, or fasting glucose fingerstick ≥ 126 mg/dL
• Taking any medications to treat high blood sugar such as metformin
• Personal history of invasive or in situ breast cancer
• Personal history of cancer other than breast: exceptions are non-melanoma skin cancer and cervical neoplasia (CIN)
• ≥ 2 alcoholic drinks/day
• Contraindications to exercise
• Abnormalities on screening physical that contraindicate participation
• Contraindications for entry into a research exercise program: recent (within 6 months) myocardial infarction, pulmonary edema, myocarditis, pericarditis, unstable angina, pulmonary embolism, deep vein thrombosis, uncontrolled hypertension (systolic > 200, diastolic > 100), orthostatic hypotension, moderate/severe aortic stenosis, uncontrolled arrhythmia, uncontrolled congestive heart failure, left bundle branch block, history of cardiac arrest or stroke
• Frequent marijuana use (> 1 per month)
• Alcohol or drug abuse, significant mental illness (as assessed by study staff impression)
• History of clotting disorders (muscle-biopsy sub study)
• Unable or unwilling to stop aspirin or nonsteroidal antiinflammatory drugs (NSAIDs) for 48 hours before and after the procedure (muscle-biopsy sub study)
• Allergy to anesthetics or local anesthetics (muscle-biopsy sub study)
• Long term use of warfarin or similar medications (muscle-biopsy sub study)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm I (acute exercise); Participants undergo a moderate-intensity acute exercise bout over 45 minutes.	Other: Questionnaire Administration; Ancillary studies; Other: Biomarker Analysis; Correlative studies; Behavioral: Exercise Intervention; Undergo acute exercise
Active Comparator: Arm II (rest); Participants rest by sitting for 45 minutes.	Other: Questionnaire Administration; Ancillary studies; Other: Biomarker Analysis; Correlative studies; Other: Resting; Seated resting; Other Names: Rest

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean change in homeostatic model assessment of insulin resistance (HOMA-IR)	Will compare the average changes in HOMA-IR from baseline to 45 minutes between the exercisers and controls.	Baseline up to 45 minutes
Mean change in HOMA-IR	Will compare the average changes in HOMA-IR from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes
Change in insulin level	Will compare changes in insulin level from baseline to 45 minutes between the exercisers and controls.	Baseline up to 45 minutes
Change in insulin level	Will compare changes in insulin level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes
Change in glucose level	Will compare changes in glucose level from baseline to 45 minutes between the exercisers and controls.	Baseline up to 45 minutes
Change in glucose level	Will compare changes in glucose level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes
Change in Vascular Endothelial Growth Factor (VEGF) level	Will compare changes in VEGF level from baseline to 45 minutes between the exercisers and controls.	Baseline up to 45 minutes
Change in VEGF level	Will compare changes in VEGF level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes
Change in Irisin level	Will compare changes in Irisin level from baseline to 45 minutes between the exercisers and controls.	Baseline up to 45 minutes
Change in Irisin level	Will compare changes in Irisin level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes
Change in Plasminogen activator inhibitor type-1 (PAI-1) level	Will compare changes in PAI-1 level from baseline to 45 minutes between the exercisers and controls.	Baseline up to 45 minutes
Change in PAI-1 level	Will compare changes in PAI-1 level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effects of exercise on HOMA-IR in normal-weight participants	Will use the generalized estimating equations (GEE) model including the potential effect modification of weight category (normal weight versus [vs] overweight/obese) to compare the 45-minute exercise session on HOMA-IR in normal-weight versus overweight/obese women.	At 45 minutes
Effects of exercise on HOMA-IR in overweight/obese participants	Will use the GEE model including the potential effect modification of weight category (normal weight versus [vs.] overweight/obese) to compare the 45-minute exercise session on HOMA-IR in normal-weight versus overweight/obese women.	At 45 minutes
Change in C-reactive protein (CRP)	Will compare changes in CRP level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes
Change in Interleukin (IL)-6	Will compare changes in IL-6 level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes
Change in Monocyte chemotactic protein (MCP)-1	Will compare changes in MCP-1 level from baseline to 105 minutes between the exercisers and controls.	Baseline up to 105 minutes

Collaborators and Investigators

• Sponsor: Fred Hutchinson Cancer Center
• Collaborators: Breast Cancer Research Foundation
• Investigators: Principal Investigator: Anne McTiernan, Fred Hutch/University of Washington Cancer Consortium

Study record dates

Study Major Dates

• Study Start (Actual): March 25, 2019
• Primary Completion (Actual): December 31, 2024
• Study Completion (Actual): December 31, 2024

Study Registration Dates

• First Submitted: December 17, 2018
• First Submitted That Met QC Criteria: December 17, 2018
• First Posted (Actual): December 19, 2018

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 21, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Skin Diseases; Breast Diseases; Breast Neoplasms
• Other Study ID Numbers: RG1003977; NCI-2018-02831 (Registry Identifier: CTRP (Clinical Trial Reporting Program)); 8766 (Other Identifier: Fred Hutch/University of Washington Cancer Consortium)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No