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Nicht-chemotherapeutische Interventionen zur Verbesserung der Lebensqualität und Immunfunktion bei Patienten mit multiplem Myelom

4. November 2026 aktualisiert von: Roswell Park Cancer Institute

Verbesserung der Wirtsfaktoren bei Patienten mit monoklonalen Gammopathien

This clinical trial investigates the effect of non-chemotherapeutic interventions in patients with multiple myeloma or MDS. Non-chemotherapeutic interventions such as physical activity and nutritional interventions (e.g., modifications in diet) have been shown to positively affect the immune system and improve overall quality of life. Another purpose of this study is for researchers to learn how the addition of a beta-blocker (propranolol) to the standard treatment regimen in patients with newly diagnosed multiple myeloma affects immune response and quality of life. A study from the Mayo Clinic looked at multiple myeloma patients who were on a beta-blocker while undergoing chemotherapy and found that the use of a beta-blocker resulted in improved patient survival outcomes. Non-chemotherapeutic treatment options may help decrease symptoms and improve quality of life for patients with multiple myeloma.

Studienübersicht

Detaillierte Beschreibung

PRIMARY OBJECTIVES:

I. To assess the impact of different lifestyle and low side effect interventions (exercise, nutrition, stress effects reduction) on immune markers in patients with monoclonal plasma cell and other hematologic disorders.

SECONDARY OBJECTIVES:

I. To assess the impact of different lifestyle and low side effect interventions (exercise, nutrition) on bone turnover parameters, body composition, the microbiome and physical fitness in patients with monoclonal plasma cell and other hematologic disorders.

II. To assess the impact of different lifestyle and low side effect interventions (exercise, nutrition, stress effect reduction) on parameters of stress, mental health and quality of life in patients with monoclonal plasma cell and other hematologic disorders.

OUTLINE: Patients are assigned to Module A, B C , D. (MDS patients will only be assigned in Module D) or E.

MODULE A: Patients undergo strength training sessions twice weekly supervised by a licensed and specialized personal trainer via the internet (e.g., remote access) for 6 months. Patients also wear a FitBit device and receive prompts via email or text on a cell phone or other electronic device to incrementally increase physical activity over 6 months.

MODULE B: Patients undergo intermittent fasting for 1 month. This consists of restricting all eating to a consecutive 8-hour time period each day followed by 16 consecutive hours of not eating.

MODULE C: Patients are assigned to group 1 (are not currently taking beta-blockers) or group 2 (current taking beta-blockers).

GROUP I: Patients receive propranolol orally (PO) twice daily (BID) for 3 months.

GROUP II: Patients continue receiving beta-blocker regimen as per standard of care (SOC) for 3 months.

MODULE D: Patients will receive resistance training twice a week for 6 months.

MODULE E: Patients undergo resistance training sessions twice weekly supervised by a licensed and specialized personal trainer via the internet (e.g., remote access) for 9 months. Patients also wear a FitBit device and receive prompts via email or text on a cell phone or other electronic device to incrementally increase physical activity over 9 months. Patients also undergo DEXA scans on study and collection of blood samples and bone marrow biopsy (as indicated for clinical care) throughout the trial

After completion of the study interventions, patients in module A and D are followed every 3 months for 1 year. Patients in module B are followed at 3 and 5 months. Patients in modules C and E are followed for 3 months.

Studientyp

Interventionell

Einschreibung (Geschätzt)

265

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Age >= 18 years of age

  • Have an Eastern Cooperative Oncology Group (ECOG) Performance Status of:

    • Module A: ECOG 0 - 1
    • Module B: ECOG 0 - 2
    • Module C: ECOG 0 - 2
    • Module D: ECOG 0-1
    • Module E: ECOG 0-1
  • MODULE A -C: Have a diagnosis of smoldering multiple myeloma, multiple myeloma or plasma cell leukemia (PCL) or

  • MODULE D: non transfusion dependent low-risk MDS

  • Show no signs of comorbidities, myeloma symptoms, or treatment side effects that would put them in danger when participating in the study according to the physician's discretion

  • Are able to understand and follow assessment and intervention procedures

  • Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

  • MODULE A, D and E: (PHYSICAL ACTIVITY): Participant has access to a personal computer or tablet with camera, microphone, speakers and internet access

  • MODULE B (NUTRITION): Not applicable

  • MODULE C (BETA BLOCKER): Newly diagnosed patients with multiple myeloma necessitating treatment and before initiation of systemic therapy

  • MODULE C: Female participants of child-bearing potential must have a negative pregnancy test at study entry and then agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry. Male patients with female partners of child-bearing potential should also use adequate contraceptive methods (see above). Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately MODULE D (PHYSICAL ACTIVITY): Patients with MDS not necessitating transfusion therapy at time of enrollment (no transfusion within 8 weeks prior to enrollment) i.e. patients on observation, or receiving growth factors or luspatercept only

    • MODULE E (EX-MT): Have a planned autologous stem cell transplant (ASCT) for front line therapy
    • MODULE E (EX-MT): Be enrolled in the Biorepository and Laboratory Services (BLS) Universal Consent with completed epidemiological questionnaire
    • MODULE E (EX-MT): Report being inactive or low active during the peri-diagnosis and treatment period leading up to study enrollment
    • MODULE E (EX-MT): Participant has access to a personal computer or tablet with camera, microphone, speakers and internet access
    • MODULE E (EX-MT): Receive appropriate medical clearances to exercise

Exclusion Criteria:

  • Major comorbidities that would cause danger to the patient when participating in the study and that would have a risk of progression if the patient took part in the study (including, but not limited to): cardiac or pulmonary and infectious diseases (e.g., ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia) or, psychiatric illness/social situations that would limit compliance with study requirements
  • Unwilling or unable to follow protocol requirements
  • Any condition which in the investigator's opinion deems the participant an unsuitable candidate to take part in study intervention (comorbidities, myeloma symptoms, treatment side effects)
  • MODULE A and E:(PHYSICAL ACTIVITY): Current and symptomatic pathological fracture(s) or severely advanced instability of the musculo-skeletal system that is deemed to making the patient unsafe to participate. This will be assessed by radiologist, a neurosurgeon and/or an orthopedic surgeon, if applicable.
  • MODULE A and E: (PHYSICAL ACTIVITY): Current and symptomatic pathological fracture(s) or severely advanced instability of the musculo-skeletal system
  • MODULE A and E: (PHYSICAL ACTIVITY): Acute bone instability as assessed by whole body low-dose computed tomography and evaluated by an experienced surgeon
  • MODULE B (NUTRITION): Clinical signs of malnutrition (body mass index [BMI] < 18)
  • MODULE B (NUTRITION): Special diets (physician prescribed)
  • MODULE B (NUTRITION): Diabetic treated with glucose-lowering medications and/or insulin
  • MODULE B (NUTRITION): Other reasons not to withhold food
  • MODULE B (NUTRITION): Any condition which in the investigator's opinion deems the participant an unsuitable candidate to limit food consumption
  • MODULE C (BETA BLOCKER): Current use of a beta blocker (includes all non-selective and beta-1 selective blockers) or, use of a beta-blocker within 3 months of study enrollment
  • MODULE C (BETA BLOCKER): Contraindications to the use of beta-blockers, e.g.; severe sinus bradycardia; sick sinus syndrome; or heart block greater than first-degree, uncontrolled depression, unstable angina pectoris, uncontrolled heart failure (New York Heart Association [NYHA] Grade III or IV), hypotension ( systolic blood pressure < 100 mmHg), severe asthma or chronic obstructive pulmonary disease (COPD), uncontrolled type I or type II diabetes mellitus (HbA1C > 8.5 or 12h fasting plasma glucose > 160 mg/dL at screening), symptomatic peripheral arterial disease or Raynaud's syndrome, untreated pheochromocytoma, current calcium channel blocker use (Non-dihydropyridines such as verapamil) or rhythm control agents such as digoxin and amiodarone. Patients with pacemakers will be excluded
  • MODULE C (BETA BLOCKER): Pregnant or nursing female participants, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive human chorionic gonadotropin (hCG) laboratory test
  • MODULE D: Cardiovascular disease which is deemed limiting exercise readiness by a cardiologist

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Nicht randomisiert
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Module A (strength training, behavioral intervention)

Patients undergo strength training sessions twice weekly supervised by a licensed and specialized personal trainer via the internet (e.g., remote access) for 6 months. Patients also wear a FitBit device and receive prompts via email or text on a cell phone or other electronic device to incrementally increase physical activity over 6 months.

Ancillary studies

Andere Namen:
  • Bewertung der Lebensqualität

Ancillary studies

Wear a FitBit device and receive prompts for 6 months

Andere Namen:
  • Verhaltenskonditionierungstherapie
  • Verhaltensänderung
  • Verhaltens- oder Lebensstiländerungen
  • Verhaltenstherapie
  • Verhaltensinterventionen
  • Verhaltensbehandlung
  • Verhaltensbehandlungen

Undergo strength training for 6 months

Andere Namen:
  • Krafttraining
Experimental: Module B (intermittent fasting)

Patients undergo intermittent fasting for 1 month. This consists of restricting all eating to a consecutive 8-hour time period each day followed by 16 consecutive hours of not eating.

Ancillary studies

Andere Namen:
  • Bewertung der Lebensqualität

Ancillary studies

Participate in intermittent fasting

Andere Namen:
  • Intermittierende Fasten
  • Kurzfristiges intermittierendes Fasten
Experimental: Module C Group I (propranolol)

Patients receive propranolol PO BID for 3 months.

Ancillary studies

Andere Namen:
  • Bewertung der Lebensqualität

Ancillary studies

Given PO

Andere Namen:
  • 1-[(1-Methylethyl)amino]-3-(1-naphthalinyloxy)-2-propanol
Aktiver Komparator: Module C Group II (propranolol)

Patients continue receiving beta-blocker regimen as per SOC for 3 months.

Ancillary studies

Andere Namen:
  • Bewertung der Lebensqualität

Ancillary studies

Receive beta-blocker regimen as per SOC

Andere Namen:
  • Betablocker
  • Beta-adrenerger Blocker
Experimental: Module D

MDS Patients undergo strength training for 6 months.

Wear a FitBit device and receive prompts for 6 months

Andere Namen:
  • Verhaltenskonditionierungstherapie
  • Verhaltensänderung
  • Verhaltens- oder Lebensstiländerungen
  • Verhaltenstherapie
  • Verhaltensinterventionen
  • Verhaltensbehandlung
  • Verhaltensbehandlungen

Undergo strength training for 6 months

Andere Namen:
  • Krafttraining
Experimental: Module E

Patients undergo resistance training sessions twice weekly supervised by a licensed and specialized personal trainer via the internet (e.g., remote access) for 9 months. Patients also wear a FitBit device and receive prompts via email or text on a cell phone or other electronic device to incrementally increase physical activity over 9 months. Patients also undergo DEXA scans on study and collection of blood samples and bone marrow biopsy (as indicated for clinical care) throughout the trial.

Wear a FitBit device and receive prompts for 6 months

Andere Namen:
  • Verhaltenskonditionierungstherapie
  • Verhaltensänderung
  • Verhaltens- oder Lebensstiländerungen
  • Verhaltenstherapie
  • Verhaltensinterventionen
  • Verhaltensbehandlung
  • Verhaltensbehandlungen

Undergo strength training for 6 months

Andere Namen:
  • Krafttraining

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Changes in immune cell subsets
Zeitfenster: At baseline and at 1 year

Will be assessed by flow cytometry, comparing levels before and after one of three lifestyle interventions (physical exercise, intermittent fasting, beta blocker therapy). Will use a linear mixed model. Since the form of the model is unknown a priori, the power calculations are based on comparing any two timepoints using a two-sided paired t-test. With n=100, we have 80% power (at alpha = 0.05/3) to detect a difference of at least 0.33 standard deviations (SD).

At baseline and at 1 year

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Changes in the gut microbiome
Zeitfenster: At 1 and 3 months

Fecal samples will be collected and compared from group with physical exercise,compared to group doing intermittent fasting).

At 1 and 3 months
Comparison in bone markers
Zeitfenster: At 1 and 3 months

Will be assessed from intermittent fasting serum samples compared to serum samples of those doing physical exercise.

At 1 and 3 months
Changes in body composition
Zeitfenster: 3 months

Dexa (bone density scan) will be performed at 1 and 3 months

3 months
Changes in stress
Zeitfenster: At 1 and 3 months

Significant differences among groups in the mean Perceived Stress Scale (PSS) score, which measures the stress severity perceived by the subjects in the last month. The scale is constituted by 10 items that are self-rated by the subject on a 0-4 Likert scale. The scale minimum total score is 0, the maximum is 40. Higher total scores indicate a worse outcome

At 1 and 3 months
Changes in anxiety
Zeitfenster: At 1 and 3 months

As assessed by the Generalized Anxiety Disorder 7-item Scale

At 1 and 3 months
Changes in fatigue as assessed by EORTC-LQLQ-FA12
Zeitfenster: At 1 and 3 months

12-item multidimensional fatigue questionnaire.The scale scores from 1 to 4: 1 ("Not at all"), 2 ("A little"), 3 ("Quite a bit") and 4 ("Very much"). The range is 3. For the raw score, less points are considered to have a better outcome.

At 1 and 3 months
Change in functional status
Zeitfenster: At 1 and 3 months

basic assessment of physical activity before diagnosis will be compared to one administered at follow up

At 1 and 3 months
Changes in nutritional behavior before and after intermittent fasting
Zeitfenster: Up to 5 months

Will be modeled using a GEE logistic model. Rates of positive nutritional behavior will be compared beween time points.

Up to 5 months
Changes in stress-related biomarkers
Zeitfenster: Up to 6 months

Will be evaluated using a linear mixed model and will be used to compare mean levels between timepoints.

Up to 6 months

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Ermittler

  • Hauptermittler: Jens Hillengass, Roswell Park Cancer Institute

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

28. Juni 2022

Primärer Abschluss (Geschätzt)

28. Juni 2027

Studienabschluss (Geschätzt)

28. Juni 2027

Studienanmeldedaten

Zuerst eingereicht

18. März 2022

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

28. März 2022

Zuerst gepostet (Tatsächlich)

5. April 2022

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

9. November 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

4. November 2026

Zuletzt verifiziert

1. November 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • I 1680221
  • I 1680221 (Andere Kennung: Roswell Park Cancer Institute)
  • NCI-2022-01918 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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