Exercise and Tumor Blood Flow in Lymphoma And Breast Cancer Patients (EXETUMOR 3) (EXETUMOR3)

July 26, 2021 updated by: Ilkka Heinonen, Turku University Hospital

Tumor Blood Flow After Physical Exercise in Breast Cancer and Lymphoma Patients (Exetumor3 Study)

Recent pre-clinical studies strongly suggest that due to dysfunctional vasculature and blunted sympathetic constriction in the tumor, tumor blood flow is increased even by 200% compared to resting values. However, to the best of our knowledge these blood flow aspects have never been addressed clinically. Therefore, this research aims at investigating tumor blood flow response to exercise in human cancer patients. To address this goal, in total twenty (20) newly diagnosed breast cancer and eight (8) lymphoma patients will be recruited for the present acute exercise and tumor perfusion clinical trial. To study the effect of acute physical exercise on tumor blood flow and its heterogeneity, 30 minute bicycle exercise will be used to exercise these patients. Tumor blood flow will be measured by positron emission tomography at rest before and after the exercise. If the hypothesis of increased blood flow in response to exercise will be detected, this project has the potential to increase the basic physiological and mechanistic understanding of tumor microvasculature function in humans, which is also clinically highly relevant and can have long-lasting influences in the field in the future. Thus, the results from the project can be a breakthrough for cancer treatment, its mechanistic arguments, and thus renewal of evidence-based medicine and patient care.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

In regards to cancer, it would be reasonable to assume that also cancer behaves like all other inactive tissues in a body during exercise, meaning that also blood flow in the tumor environment is reduced particularly when exercise intensity increases. However, recent pre-clinical studies suggest that due to dysfunctional vasculature and blunted sympathetic constriction in the tumor, tumor blood flow is increased even by 200% compared to resting values (6; 18; 19) as increased cardiac output and blood pressure enhance perfusion pressure in the tumor. This improves its oxygenation (6; 18; 19), which is important as tumor hypoxia negatively affects the efficacy of treatment (27). Tumor hypoxia is promoted by heterogeneous blood flow in the tumor, but according to these pre-clinical studies exercise reduces the heterogeneity of tumor perfusion. However, it is not currently known if this is the case in patients, and it might be that tumor perfusion is actually decreased during exercise, but increased post-exercise, but this has never been addressed in clinical patients and is therefore the aim of the present study. Importantly, advanced imaging methods are available to investigate whether these pre-clinical findings can be extended to humans to serve as an evidence based proof-of-concept for the possible inclusion of exercise in the treatment of cancer during chemotherapy.

OBJECTIVES AND PURPOSE

The most important objective of this directly translatable and highly inter- disciplinary imaging, physical activity, health and medical research in the acute exercise study setting is:

To investigate whether acute moderate intensity exercise increases tumor blood flow

-It is hypothesized and expected that exercise increases tumor blood flow, documented as perfusion increase after acute exercise

STUDY DESIGN Each subject will serve their own control (tumor blood flow at rest vs. blood flow after exercise). Tumor blood flow will be measured with positron emission tomography (PET). To study the effect of acute physical exercise on tumor blood flow and its heterogeneity, bicycle exercise before PET scan will be used to exercise breast cancer and lymphoma cancer patients. These experiments are additional measurements to their normal treatments, and no new interventional approaches will be conducted in this study.

Study Type

Interventional

Enrollment (Anticipated)

28

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 Locations

  • Finland
      • Turku, Finland, 20521
        • Recruiting
        • Turku PET Centre

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 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • a disease of newly diagnosed breast cancer, Hodgkin lymphoma, recurrent Hodgkin lymphoma and non-Hodgkin lymphoma with neck and thorax involvement.

Exclusion Criteria:

  • abnormal fatigue, anemia, or physical dysfunction due to the disease

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: Basic Science
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental arm
Blood flow of the tumor experimented
Procedure: Exercise
Tumor blood flow after acute exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood flow
Time Frame: up to 12 months
Blood flow measured by PET imaging
up to 12 months

Collaborators and Investigators

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

Sponsor

Turku University Hospital

Investigators

  • Principal Investigator: Ilkka Heinonen, Turku PET Centre

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 (Anticipated)

August 10, 2021

Primary Completion (Anticipated)

December 31, 2022

Study Completion (Anticipated)

December 31, 2022

Study Registration Dates

First Submitted

June 3, 2021

First Submitted That Met QC Criteria

July 26, 2021

First Posted (Actual)

August 5, 2021

Study Record Updates

Last Update Posted (Actual)

August 5, 2021

Last Update Submitted That Met QC Criteria

July 26, 2021

Last Verified

July 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • T06/024/21

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Yes

IPD Sharing Time Frame

up to 12 months

IPD Sharing Supporting Information Type

  • Study Protocol
  • Statistical Analysis Plan (SAP)
  • Informed Consent Form (ICF)
  • Clinical Study Report (CSR)

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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