Exercise Intervention in Targeting Adiposity and Inflammation With Movement to Improve Prognosis in Breast Cancer
21 de octubre de 2019 actualizado por: University of Southern California
Taking AIM at Breast Cancer: Targeting Adiposity and Inflammation With Movement to Improve Prognosis in Breast Cancer Survivors
This randomized phase II trial studies how well exercise intervention works in targeting adiposity and inflammation with movement to improve prognosis in stage I-III breast cancer survivors.
Different types of exercise may reduce inflammation in fat tissue and minimize the risk of cancer recurrence related to being overweight or obese.
Descripción general del estudio
Estado
Retirado
Condiciones
- Cáncer de mama en estadio I
- Sobreviviente de cáncer
- Cáncer de mama en estadio II
- Cáncer de mama en estadio IIIA
- Cáncer de mama en estadio IIIB
- Cáncer de mama en estadio IA
- Cáncer de mama en estadio IB
- Cáncer de mama en estadio IIA
- Cáncer de mama en estadio IIB
- Cáncer de mama en estadio IIIC
- Receptor de estrógeno positivo
- Receptor de progesterona positivo
- Cáncer de mama en estadio III
- Posmenopáusica
- Obesidad central
Descripción detallada
PRIMARY OBJECTIVES:
I. To determine the effects of a 4-month circuit, interval-based aerobic and resistance exercise (CARE) intervention on obesity-associated chronic inflammation.
SECONDARY OBJECTIVES:
I. To determine the effects of a 4-month CARE intervention on sarcopenic obesity.
TERTIARY OBJECTIVES:
I. To determine the effects of a 4-month CARE intervention on breast cancer prognosis and assess whether reductions in chronic inflammation are associated with breast cancer prognosis.
OUTLINE: Patients are randomized to 1 of 3 groups.
GROUP I: Patients undergo supervised CARE program over 50 minutes comprising of warm up over 5 minutes, moderate to vigorous aerobic and resistance exercises over 40 minutes, and cool down over 5 minutes 3 days per week for 16 weeks.
GROUP II: Patients undergo supervised traditional aerobic and resistance exercise (TARE) program over 80 minutes comprising of warm up over 5 minutes, aerobic exercise over 15 minutes, resistance exercise over 55 minutes, and cool down over 5 minutes 3 days per week for 16 weeks.
GROUP III: Patients undergo home-based stretching program comprising of one set of 3-4 static stretching exercises held for 30 seconds 3 days per week for 16 weeks. Patients receive instructional digital video disc (DVD) and booklet of the flexibility exercises. Patients also complete a weekly activity log. After completion of the stretching program, patients may optionally undergo the CARE program as in group I.
After completion of study, patients are followed up at week 34, 8 and 12 months, and then every year for 8 years.
Tipo de estudio
Intervencionista
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
-
-
California
-
Los Angeles, California, Estados Unidos, 90033
- USC / Norris Comprehensive Cancer Center
-
-
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Femenino
Descripción
Inclusion Criteria:
- Postmenopausal (at time of diagnosis; including artificial menopause induced by previous hysterectomy) women newly diagnosed (stage I-III) breast cancer low grade disease positive for estrogen and progesterone receptors
- Are centrally obese with the following criteria (determined by study team at eligibility screening): body mass index (BMI) > 30 kg/m^2 (calculated using height and weight; an upper limit BMI will not be set; we will rely on obtaining physicians' clearance to assess full eligibility) or body fat > 30% (estimated by bioelectrical impedance), and waist circumference > 35 inches (in)
- Have undergone a lumpectomy or mastectomy
- Have received and completed neoadjuvant or adjuvant chemotherapy and/or radiation therapy within the past 12 months
- Speak English or Spanish
- Is in breast cancer remission with no detectable disease present
- Able to initiate a supervised exercise program (free from any cardiovascular, respiratory or musculoskeletal disease or joint problems that preclude moderate physical activity)
- Free from history of chronic disease including uncontrolled diabetes, hypertension or thyroid disease
- Have not experienced a weight reduction >= 10% within past 6 months
- Currently participate in less than 60 minutes of structured exercise/week
- No planned reconstructive surgery with flap repair during trial and follow-up period
- May use adjuvant endocrine therapy if use will be continued for duration of study intervention
- Does not smoke (no smoking during previous 12 months)
- Willing to travel to the exercise facility at University of Southern California (USC)
Exclusion Criteria:
- Patients with metastatic disease
- Is not centrally obese
- Has not completed surgery, chemotherapy, or radiation treatment associated with their diagnosis
- History of any musculoskeletal, cardiorespiratory or neurological diseases that preclude the participation in exercise
- Participates in more than 60 minutes of structured exercise/week
- Is planning reconstructive surgery with flap repair during trial and follow-up period
- Currently smokes
- Is unable to travel to the exercise facility at USC
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Cuidados de apoyo
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Experimental: Group I (CARE program)
Patients undergo supervised CARE program over 50 minutes comprising of warm up over 5 minutes, moderate to vigorous aerobic and resistance exercises over 40 minutes, and cool down over 5 minutes 3 days per week for 16 weeks.
|
Estudios correlativos
Estudios complementarios
Otros nombres:
Estudios complementarios
Undergo supervised CARE program
Undergo supervised TARE program
Undergo home-based stretching program
|
|
Experimental: Group II (TARE program)
Patients undergo supervised TARE program over 80 minutes comprising of warm up over 5 minutes, aerobic exercise over 15 minutes, resistance exercise over 55 minutes, and cool down over 5 minutes 3 days per week for 16 weeks.
|
Estudios correlativos
Estudios complementarios
Otros nombres:
Undergo supervised CARE program
Undergo supervised TARE program
Undergo home-based stretching program
|
|
Comparador activo: Group III (home-based stretching program)
Patients undergo home-based stretching program comprising of one set of 3-4 static stretching exercises held for 30 seconds 3 days per week for 16 weeks.
Patients receive instructional DVD and booklet of the flexibility exercises.
Patients also complete a weekly activity log.
After completion of the stretching program, patients may optionally undergo the CARE program as in group I.
|
Estudios correlativos
Estudios complementarios
Otros nombres:
Estudios complementarios
Undergo supervised CARE program
Undergo supervised TARE program
Undergo home-based stretching program
Receive instructional DVD and booklet of the flexibility exercises
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Reduction of adipose tissue inflammation assessed by measuring M1 and M2 adipose tissue macrophages, crown-like structures, and adipose tissue secretion levels of inflammatory cytokines secreted
Periodo de tiempo: Up to 16 weeks
|
Analyses for each of the continuous outcomes will involve mixed effects linear regression models, to incorporate the repeatedly measured outcomes.
Dependent variables will be the 2- and 4-month measurements of trial outcomes assessed during and at the end of the intervention period.
Independent variables will include two indicator variables for treatment group (TARE, attention control) relative to CARE, the baseline value of the outcome, and an indicator variable for measurement time (2-month/4-month).
The treatment group effect (2 degrees of freedom) will test for differences in TARE and/or attention control, relative to CARE on the 2- and 4-month outcomes.
|
Up to 16 weeks
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Distant DFS defined as events that are either lethal (death from any cause) or a direct threat to patient survival (distant recurrence or second primary invasive cancer)
Periodo de tiempo: Up to 8 years
|
Kaplan-Meier estimates and log-rank tests will be used to estimate and initially test cumulative survival probabilities by treatment group.
Cox proportional hazards models will be used to compare treatment groups (with 2 indicator variables for treatment group).
|
Up to 8 years
|
|
Overall survival
Periodo de tiempo: From randomization to death from any cause, assessed up to 8 years
|
Kaplan-Meier estimates and log-rank tests will be used to estimate and initially test cumulative survival probabilities by treatment group.
Cox proportional hazards models will be used to compare treatment groups (with 2 indicator variables for treatment group).
|
From randomization to death from any cause, assessed up to 8 years
|
|
Recurrence-free interval defined as events directly attributable to the original breast cancer including invasive ipsilateral breast tumor recurrence; local, regional or distant recurrence; and death from breast cancer
Periodo de tiempo: Up to 8 years
|
A competing risks analysis will be conducted, with death modeled as a competing event, using the Fine-Gray proportional hazards model.
Analyses will be presented unadjusted, as well as adjusted for prognostic variables (age, estrogen receptor (ER)/HER2 status, tumor size, presence/number of positive nodes, and surgery (mastectomy vs. breast-sparing).
|
Up to 8 years
|
|
Sarcopenic obesity assessed using dual energy X-ray absorptiometry
Periodo de tiempo: Up to 8 months
|
Analyses for each of the continuous outcomes will involve mixed effects linear regression models, to incorporate the repeatedly measured outcomes.
Dependent variables will be the 2- and 4-month measurements of trial outcomes assessed during and at the end of the intervention period.
Independent variables will include two indicator variables for treatment group (TARE, attention control) relative to CARE, the baseline value of the outcome, and an indicator variable for measurement time (2-month/4-month).
The treatment group effect (2 degrees of freedom) will test for differences in TARE and/or attention control, relative to CARE on the 2- and 4-month outcomes.
|
Up to 8 months
|
Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Disease free survival (DFS)
Periodo de tiempo: From randomization to documentation of disease recurrence or death from any cause, assessed up to 8 years
|
Kaplan-Meier estimates and log-rank tests will be used to estimate and initially test cumulative survival probabilities by treatment group.
Cox proportional hazards models will be used to compare treatment groups (with 2 indicator variables for treatment group).
Ancillary analyses will assess associations of inflammation measures with DFS.
Results will be presented as hazard ratios, with 95% confidence intervals.
Unadjusted and adjusted survival curves will be presented by treatment group.
|
From randomization to documentation of disease recurrence or death from any cause, assessed up to 8 years
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Christina Dieli-Conwright, PhD, University of Southern California
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Anticipado)
29 de julio de 2019
Finalización primaria (Anticipado)
29 de julio de 2024
Finalización del estudio (Anticipado)
29 de julio de 2025
Fechas de registro del estudio
Enviado por primera vez
21 de marzo de 2017
Primero enviado que cumplió con los criterios de control de calidad
21 de marzo de 2017
Publicado por primera vez (Actual)
27 de marzo de 2017
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
24 de octubre de 2019
Última actualización enviada que cumplió con los criterios de control de calidad
21 de octubre de 2019
Última verificación
1 de octubre de 2019
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 1B-16-11 (Otro identificador: USC / Norris Comprehensive Cancer Center)
- P30CA014089 (Subvención/contrato del NIH de EE. UU.)
- NCI-2017-00070 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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