Diet Modification in pAtients With Luminal Early Breast Cancer Candidate for Primary Surgery (MACS)

February 8, 2024 updated by: Institut du Cancer de Montpellier - Val d'Aurelle

Trial Studying the Feasibility of a Diet Modification in pAtients With Luminal Early Breast Cancer Candidate for Primary Surgery

to analyze the feasibility for patients with early luminal breast cancer to be compliant with a diet modification - ketogenic or proteins restricted diet - during 9 +/- 1 days, before breast cancer surgery.

It's a Pilot study, monocentric, randomized

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Many patients are modifying their diet after the diagnosis of cancer. There is a supposedly benefit, among the general public, of starving cancer cells with several diet deprivations.

Due to the lack of coherent scientific data, no evidence base recommendations can be made regarding the optimal diet during cancer and its effect on cancer growth.

The objective of this trial is to analyze the feasibility for patients with early luminal breast cancer to be compliant with a diet modification - ketogenic or proteins restricted diet - during 9 +/- 1 days, before breast cancer surgery.

The primary objective of the trial is to evaluate the compliance to the proposed diet.

The study will be conducted in patients with luminal early breast cancer, candidate to primary surgery, in order to study an homogeneous population of patients, with good performance status and without nutritional deprivation.

Metabolic changes on the main metabolic pathways and the potential antitumor effects related to these metabolic changes following the diet will be analyzed as secondary objectives of the study. We hope to find biological hypotheses to further test in a next larger prospective trial.

The impact of the patient's beliefs, anxiety and/or depression on the compliance will be analyzed as well.

Study Type

Interventional

Enrollment (Estimated)

75

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • France
    • Herault
      • Montpellier, Herault, France, 34298
        • Recruiting
        • ICM Val d'Aurelle
        • Contact:
          • Veronique D'HONDT, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Women 18 to 80 years old
  • Invasive breast carcinoma, non-metastatic, stage I to III, pathologically proven, ER and/or PR positive, HER2 negative (luminal)
  • No treatment yet for the current breast cancer
  • Candidate for primary surgery
  • Body mass index (BMI) between 18.5 and 30 for women up to 70 years old and between 21 and 30 for women between 70 and 80 years old.
  • For patient ≥ 70 years, score of the Oncodage G8 questionnaire > 14 (if score ≤ 14, consultation with an oncogeriatrician required to validate the possibility of following a diet
  • No addiction (alcohol, tobacco, drug, electronic cigarette) that modifies the metabolism (alcohol : ≤ 2 glasses/d or ≤10 glasses/week ; tobacco : only occasional or stopped for ≥ 6 months)
  • Performance status 0-1
  • Fasting blood test :

Blood cell counts : Neutrophils > 1000/µL, Platelets > 100 000/µL, Hb > 11g/dL Hepatic biology: GOT, GPT, GGT, Phosphatases alcalines < 2x normal value Renal function : clearance > 60 mL /min Lipid profile : Total cholesterol < 1.5 x normal value, HDL>0.35g/L, LDL < 2.2 g/L (<5.7 mml/L), Triglycerides < 1.5 x normal value Fasting blood glucose < 1.26 g/l Measurement of electrolytes: Potassium, Sodium, Calcium, Magnesium (according to normal laboratory values)

  • ECG with a QTc interval ≤ 450 msec
  • Patient able to understand, participate and give a written consent for participation to the study

Exclusion Criteria:

  • Metabolic disease or other disease impairing the metabolism analysis
  • High level athlete
  • Unintentional weight loss ≥ 5% during the last month, or 10% during the last 6 months or compared to usual weight
  • Unjustified dietary supplement (not justified by a measured deficiency) during the last month
  • Restricted of unbalanced diet (vegan diet, restricted hypocaloric, hyper or hypo protein…) during the last month
  • Practice of fasting during the last 3 months
  • Corticoids that can't be stopped or not stopped for 2 weeks
  • Mellitus diabetes (with or without insulin)
  • Hypercholesterolemia requiring a treatment
  • Invasive lobular carcinoma
  • Pregnant or breast-feeding women
  • Participation to another study with an investigational treatment during the last 30 days
  • Individuals under the protection of a conservator
  • Unaffiliated patient to Social Protection System.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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
No Intervention: control arm
In the control arm, patients will continue their usual diet without further recommendation.
Experimental: specific diet arm "Ketogenic arm"
In the specific diet arms, the study diet will be calculated with a dietician, for the ketogenic diet, an iso-caloric ketogenic will be proposed and explained to the patient Each diet will be respected by the patient during 9 days +/- 1 day.
Dietary supplement: iso-caloric ketogenic diet
Each patient will be offered a daily diet plan that includes the different groups of low glycemic index foods to bring to each meal and snack, with the notion of quantity. Carbohydrate-free foods can be consumed ad libitum. Dietary advice will be given to increase the consumption of lipid foods (vegetable oils, butter, cheeses, fatty fish, etc.) so that 65% of the total energy intake is provided by lipids. In addition, a list of unauthorized sugars and sweeteners substitutes will be proposed as well as a low glycemic index food composition table centered on carbohydrates for better control of food choice
Experimental: specofoc diet arm "protein restricted diet"

In the specific diet arms, the study diet will be calculated with a dietician, for the protein restricted diet, a 20% protein restriction as compared to the usual diet will be calculated and the diet will be explained to the patient.

Each diet will be respected by the patient during 9 days +/- 1 day.
Dietary supplement: protein restricted diet
A diet reducing by 20% the amount of protein compared to the usual intake of the patient will be proposed. This new ration will be carried out by calculating the proportion of total energy intake provided by the amount of protein reduced by 20% compared to the usual intake, and by modifying lipid and carbohydrate intakes to obtain an isocaloric ration.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
study of the compliance of patients to the two proposed diets. The proportion of compliant patients to the proposed diet according to the dietary survey realized during 3 days
Time Frame: during 3 days before the primary surgery
A patient is considered compliant to the diet if the caloric intake is equal +/- 25% to the caloric intake of the proposed diet AND For the ketogenic diet : the carbohydrate intake is equal +/- 25% to the carbohydrate intake of the proposed diet; i.e. a carbohydrate intake between 7.5 and 12.5% of the total energy intake For the protein restricted diet, the protein intake is equal +/- 25% to the protein intake proposed for this diet; i.e. a reduction between 15 and 25% compared to the previous protein intake
during 3 days before the primary surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
study of the molecular consequences of diet modifications on cancer cells and their microenvironment
Time Frame: At the inclusion visit and the day of surgery
analyse markers of cell proliferation in cancer and immune cells with blood sample and tumor sample. Evaluation of markers involved in carbohydrate mitochondrial and lipid metabolism, and markers of the Pi3K-Akt-mTOR and the IGF-R pathways
At the inclusion visit and the day of surgery
study of the molecular consequences of diet modifications on cancer cells and their microenvironment
Time Frame: At the inclusion visit and the day of surgery
determine the activity of the anti-tumoral immune surveillance with blood sample and tumor sample. Correlation between the cancer response and antitumoral immune with diet programm
At the inclusion visit and the day of surgery
evaluation of patient's tolerability to those diet modifications, in terms of weight status
Time Frame: From the inclusion visit until the Day 45 post surgery
Weight surveillance (in kilograms)
From the inclusion visit until the Day 45 post surgery
evaluation of patient's tolerability to those diet modifications, in terms of adverse events
Time Frame: From the inclusion visit until the Day 45 post surgery
monitoring of adverse events related to diet (with CTCAE (Common Terminology Criteria for Adverse Events) version 5.0)
From the inclusion visit until the Day 45 post surgery
assessment of the acceptance of study participation and reasons for refusal
Time Frame: During 45 days before the surgery
Rate of patients who agreed to participate in the study compared to the total number of patients to whom the study was proposed. Collection of reasons for refusing to participate to the study
During 45 days before the surgery
determination of the impact of diet modification on patient's quality of life
Time Frame: From the inclusion visit until the Day 45 post surgery
Result of the EORTC QLQ-C30 questionnaire (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire) questionnaire
From the inclusion visit until the Day 45 post surgery
evaluation of the impact of patient's beliefs about diet and cancer on the compliance to the proposed diet.
Time Frame: From the inclusion visit until the Day 45 post surgery
Result of the questionnaire of Beliefs about diet and cancer OPINELE (Opinions concernant l'alimentation, la santé et le cancer)
From the inclusion visit until the Day 45 post surgery
evaluation of the impact of the patient's anxiety and depression level on the compliance to the proposed diet
Time Frame: From the inclusion visit until the Day 45 post surgery
Scores obtained on the HADS scale (Hospital Anxiety and Depression Scale) (if score or = 9, result is no significant, if sore is between 10 and 12, result is limit, if result is > or = 13, result is significant
From the inclusion visit until the Day 45 post surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Institut du Cancer de Montpellier - Val d'Aurelle

Investigators

  • Study Chair: Veronique D'HONDT, MD, ICM Val d'Aurelle

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 18, 2021

Primary Completion (Estimated)

March 1, 2025

Study Completion (Estimated)

March 1, 2025

Study Registration Dates

First Submitted

July 6, 2020

First Submitted That Met QC Criteria

July 8, 2020

First Posted (Actual)

July 14, 2020

Study Record Updates

Last Update Posted (Estimated)

February 9, 2024

Last Update Submitted That Met QC Criteria

February 8, 2024

Last Verified

February 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PROICM 2019-05 MAC

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

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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