A Personalized Physical Activity Program With Activity Trackers and a Mobile Phone App for Patients With Metastatic Breast Cancer: Protocol for a Single-Arm Feasibility Trial

Lidia Delrieu, Olivia Pérol, Béatrice Fervers, Christine Friedenreich, Jeff Vallance, Olivia Febvey-Combes, David Pérol, Brice Canada, Eva Roitmann, Armelle Dufresne, Thomas Bachelot, Pierre-Etienne Heudel, Olivier Trédan, Marina Touillaud, Vincent Pialoux, Lidia Delrieu, Olivia Pérol, Béatrice Fervers, Christine Friedenreich, Jeff Vallance, Olivia Febvey-Combes, David Pérol, Brice Canada, Eva Roitmann, Armelle Dufresne, Thomas Bachelot, Pierre-Etienne Heudel, Olivier Trédan, Marina Touillaud, Vincent Pialoux

Abstract

Background: About 5% of breast cancer cases are metastatic at diagnosis, and 20%-30% of localized breast cancer cases become secondarily metastatic. Patients frequently report many detrimental symptoms related to metastasis and treatments. The physical, biological, psychological, and clinical benefits of physical activity during treatment in patients with localized breast cancer have been demonstrated; however, limited literature exists regarding physical activity and physical activity behavior change in patients with metastatic breast cancer.

Objective: The primary objective of this study is to assess the feasibility of a 6-month physical activity intervention with activity trackers in patients with metastatic breast cancer (the Advanced stage Breast cancer and Lifestyle Exercise, ABLE Trial). Secondary objectives are to examine the effects of physical activity on physical, psychological, anthropometrics, clinical, and biological parameters.

Methods: We plan to conduct a single-center, single-arm trial with 60 patients who are newly diagnosed with metastatic breast cancer. Patients will receive an unsupervised and personalized 6-month physical activity program that includes an activity tracker Nokia Go and is based on the physical activity recommendation. Patients will be encouraged to accumulate at least 150 minutes per week of moderate-to-vigorous intensity physical activity. Baseline and 6-month assessments will include anthropometric measures, functional tests (eg, 6-minute walk test and upper and lower limb strength), blood draws, patient-reported surveys (eg, quality of life and fatigue), and clinical markers of tumor progression (eg, Response Evaluation Criteria In Solid Tumors criteria).

Results: Data collection occurred between October 2016 and January 2018, and the results are expected in August 2018.

Conclusions: The ABLE Trial will be the first study to assess the feasibility and effectiveness of an unsupervised and personalized physical activity intervention performed under real-life conditions with activity trackers in patients with metastatic breast cancer.

Trial registration: ClinicalTrials.gov NCT03148886; https://ichgcp.net/clinical-trials-registry/NCT03148886 (Accessed by WebCite at http://www.webcitation.org/71yabi0la).

Registered report identifier: RR1-10.2196/10487.

Keywords: activity trackers; feasibility; metastatic breast cancer; oxidative stress; physical activity.

Conflict of interest statement

Conflicts of Interest: None declared.

©Lidia Delrieu, Olivia Pérol, Béatrice Fervers, Christine Friedenreich, Jeff Vallance, Olivia Febvey-Combes, David Pérol, Brice Canada, Eva Roitmann, Armelle Dufresne, Thomas Bachelot, Pierre-Etienne Heudel, Olivier Trédan, Marina Touillaud, Vincent Pialoux. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 30.08.2018.

Figures

Figure 1
Figure 1
Participant flow chart for the Advanced stage Breast cancer Lifestyle and Exercise study, Lyon, France (PA: Physical activity).

References

    1. INCa [2018-07-23]. Les cancers en France - Edition 2017
    1. David A. Référentiel locorégional et métastatique des Cancers Cancers du sein ‐ Juin 2010. 2010. [2018-07-23]. .
    1. Beslija S, Bonneterre J, Burstein HJ, Cocquyt V, Gnant M, Heinemann V, Jassem J, Köstler WJ, Krainer M, Menard S, Petit T, Petruzelka L, Possinger K, Schmid P, Stadtmauer E, Stockler M, Van BS, Vogel C, Wilcken N, Wiltschke C, Zielinski CC, Zwierzina H, Central European Cooperative Oncology Group (CECOG) Third consensus on medical treatment of metastatic breast cancer. Ann Oncol. 2009 Nov;20(11):1771–85. doi: 10.1093/annonc/mdp261.
    1. Andre F, Slimane K, Bachelot T, Dunant A, Namer M, Barrelier A, Kabbaj O, Spano JP, Marsiglia H, Rouzier R, Delaloge S, Spielmann M. Breast cancer with synchronous metastases: trends in survival during a 14-year period. J Clin Oncol. 2004 Aug 15;22(16):3302–8. doi: 10.1200/JCO.2004.08.095.
    1. Krohe M, Hao Y, Lamoureux RE, Galipeau N, Globe D, Foley C, Mazar I, Solomon J, Shields AL. Patient-Reported Outcomes in Metastatic Breast Cancer: A Review of Industry-Sponsored Clinical Trials. Breast Cancer (Auckl) 2016 Jul;10:93–102. doi: 10.4137/BCBCR.S39385.
    1. Shen MJ, Redd WH, Winkel G, Badr H. Associations among pain, pain attitudes, and pain behaviors in patients with metastatic breast cancer. J Behav Med. 2014 Aug;37(4):595–606. doi: 10.1007/s10865-013-9529-2.
    1. Dimeo F. Effects of exercise on cancer-related fatigue. Cancer. 2001 Sep 15;92(6 Suppl):1689–93.
    1. Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010 Jun;4(2):87–100. doi: 10.1007/s11764-009-0110-5.
    1. Velthuis MJ, Agasi-Idenburg SC, Aufdemkampe G, Wittink HM. The effect of physical exercise on cancer-related fatigue during cancer treatment: a meta-analysis of randomised controlled trials. Clin Oncol (R Coll Radiol) 2010 Apr;22(3):208–21. doi: 10.1016/j.clon.2009.12.005.
    1. Zeng Y, Huang M, Cheng ASK, Zhou Y, So WKW. Meta-analysis of the effects of exercise intervention on quality of life in breast cancer survivors. Breast Cancer. 2014 Feb 26;21(3):262–274. doi: 10.1007/s12282-014-0521-7.
    1. Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncol. 2015 May;54(5):635–54. doi: 10.3109/0284186X.2014.998275.
    1. Bluethmann SM, Vernon SW, Gabriel KP, Murphy CC, Bartholomew LK. Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors. Breast Cancer Res Treat. 2015 Jan;149(2):331–42. doi: 10.1007/s10549-014-3255-5.
    1. Oldervoll LM, Loge JH, Lydersen S, Paltiel H, Asp MB, Nygaard UV, Oredalen E, Frantzen TL, Lesteberg I, Amundsen L, Hjermstad MJ, Haugen DF, Paulsen �, Kaasa S. Physical exercise for cancer patients with advanced disease: a randomized controlled trial. Oncologist. 2011 Sep;16(11):1649–57. doi: 10.1634/theoncologist.2011-0133.
    1. Headley JA, Ownby KK, John LD. The effect of seated exercise on fatigue and quality of life in women with advanced breast cancer. Oncol Nurs Forum. 2004 Sep;31(5):977–83. doi: 10.1188/04.ONF.977-983.
    1. Ligibel JA, Giobbie-Hurder A, Shockro L, Campbell N, Partridge AH, Tolaney SM, Lin NU, Winer EP. Randomized trial of a physical activity intervention in women with metastatic breast cancer. Cancer. 2016 Apr 15;122(8):1169–77. doi: 10.1002/cncr.29899. doi: 10.1002/cncr.29899.
    1. Cormie P, Galvão DA, Spry N, Joseph D, Taaffe DR, Newton RU. Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: longitudinal results of a pilot study. Support Care Cancer. 2014 Jun;22(6):1537–48. doi: 10.1007/s00520-013-2103-1.
    1. Scott JM, Iyengar NM, Nilsen TS, Michalski M, Thomas SM, Herndon J, Sasso J, Yu A, Chandarlapaty S, Dang CT, Comen EA, Dickler MN, Peppercorn JM, Jones LW. Feasibility, safety, and efficacy of aerobic training in pretreated patients with metastatic breast cancer: A randomized controlled trial. Cancer. 2018 Jun 15;124(12):2552–2560. doi: 10.1002/cncr.31368.
    1. Jones LW, Courneya KS, Mackey JR, Muss HB, Pituskin EN, Scott JM, Hornsby WE, Coan AD, Herndon JE, Douglas PS, Haykowsky M. Cardiopulmonary function and age-related decline across the breast cancer survivorship continuum. J Clin Oncol. 2012 Jul 10;30(20):2530–7. doi: 10.1200/JCO.2011.39.9014.
    1. Wright SP, Hall BTS, Collier SR, Sandberg K. How consumer physical activity monitors could transform human physiology research. Am J Physiol Regul Integr Comp Physiol. 2017 Dec 01;312(3):R358–R367. doi: 10.1152/ajpregu.00349.2016.
    1. Kooiman TJ, Dontje ML, Sprenger SR, Krijnen WP, van der Schans CP, de Groot M. Reliability and validity of ten consumer activity trackers. BMC Sports Sci Med Rehabil. 2015 Oct;7:24. doi: 10.1186/s13102-015-0018-5.
    1. Storm FA, Heller BW, Mazzà C. Step detection and activity recognition accuracy of seven physical activity monitors. PLoS One. 2015 Mar;10(3):e0118723. doi: 10.1371/journal.pone.0118723.
    1. Uhm KE, Yoo JS, Chung SH, Lee JD, Lee I, Kim JI, Lee SK, Nam SJ, Park YH, Lee JY, Hwang JH. Effects of exercise intervention in breast cancer patients: is mobile health (mHealth) with pedometer more effective than conventional program using brochure? Breast Cancer Res Treat. 2017 Dec;161(3):443–452. doi: 10.1007/s10549-016-4065-8.
    1. Mercer K, Giangregorio L, Schneider E, Chilana P, Li M, Grindrod K. Acceptance of Commercially Available Wearable Activity Trackers Among Adults Aged Over 50 and With Chronic Illness: A Mixed-Methods Evaluation. JMIR Mhealth Uhealth. 2016 Jan 27;4(1):e7. doi: 10.2196/mhealth.4225.
    1. Lyons EJ, Lewis ZH, Mayrsohn BG, Rowland JL. Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis. J Med Internet Res. 2014 Aug;16(8):e192. doi: 10.2196/jmir.3469.
    1. Sullivan AN, Lachman ME. Behavior Change with Fitness Technology in Sedentary Adults: A Review of the Evidence for Increasing Physical Activity. Front Public Health. 2016;4:289. doi: 10.3389/fpubh.2016.00289. doi: 10.3389/fpubh.2016.00289.
    1. Pedersen BK. The anti-inflammatory effect of exercise: its role in diabetes and cardiovascular disease control. Essays Biochem. 2006 Nov;42:105–17. doi: 10.1042/bse0420105.
    1. Kojda G, Hambrecht R. Molecular mechanisms of vascular adaptations to exercise. Physical activity as an effective antioxidant therapy? Cardiovasc Res. 2005 Aug 01;67(2):187–97. doi: 10.1016/j.cardiores.2005.04.032.
    1. Kang D, Lee J, Suh S, Ligibel J, Courneya KS, Jeon JY. Effects of Exercise on Insulin, IGF Axis, Adipocytokines, and Inflammatory Markers in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev. 2017 Mar;26(3):355–365. doi: 10.1158/1055-9965.EPI-16-0602.
    1. Meneses-Echávez JF, Jiménez EG, Río-Valle JS, Correa-Bautista JE, Izquierdo M, Ramírez-Vélez R. The insulin-like growth factor system is modulated by exercise in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2016 Dec 25;16(1):682. doi: 10.1186/s12885-016-2733-z.
    1. Koelwyn G, Wennerberg E, Demaria S, Jones Lee W. Exercise in Regulation of Inflammation-Immune Axis Function in Cancer Initiation and Progression. Oncology (Williston Park) 2015 Dec;29(12):908–20, 922.
    1. Idorn M, Thor SP. Exercise and cancer: from “healthy” to “therapeutic”? Cancer Immunol Immunother. 2017 May;66(5):667–671. doi: 10.1007/s00262-017-1985-z.
    1. Hussain SP, Hofseth LJ, Harris CC. Radical causes of cancer. Nat Rev Cancer. 2003 Apr;3(4):276–85. doi: 10.1038/nrc1046.
    1. Brown NS, Bicknell R. Hypoxia and oxidative stress in breast cancer. Oxidative stress: its effects on the growth, metastatic potential and response to therapy of breast cancer. Breast Cancer Res. 2001;3(5):323–7.
    1. Sinha R, Singh R, Mehrotra S, Singh R K. Implications of free radicals and antioxidant levels in carcinoma of the breast: a never-ending battle for survival. Indian J Cancer. 2009;46(2):146–50.
    1. Debevec T, Millet GP, Pialoux V. Hypoxia-Induced Oxidative Stress Modulation with Physical Activity. Front Physiol. 2017 Feb;8:84. doi: 10.3389/fphys.2017.00084. doi: 10.3389/fphys.2017.00084.
    1. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1) Eur J Cancer. 2009 Jan;45(2):228–47. doi: 10.1016/j.ejca.2008.10.026.
    1. Galiano-Castillo N, Arroyo-Morales M, Ariza-Garcia A, Sánchez-Salado C, Fernández-Lao C, Cantarero-Villanueva I, Martín-Martín L. The Six-Minute Walk Test as a Measure of Health in Breast Cancer Patients. J Aging Phys Act. 2016 Dec;24(4):508–515. doi: 10.1123/japa.2015-0056.
    1. Schmidt K, Vogt L, Thiel C, Jäger E, Banzer W. Validity of the six-minute walk test in cancer patients. Int J Sports Med. 2013 Jul;34(7):631–6. doi: 10.1055/s-0032-1323746.
    1. Borg G, Hassmén P, Lagerström M. Perceived exertion related to heart rate and blood lactate during arm and leg exercise. Eur J Appl Physiol Occup Physiol. 1987;56(6):679–85.
    1. Savva C, Giakas G, Efstathiou M, Karagiannis C. Test-retest reliability of handgrip strength measurement using a hydraulic hand dynamometer in patients with cervical radiculopathy. J Manipulative Physiol Ther. 2014 Mar;37(3):206–10. doi: 10.1016/j.jmpt.2014.02.001.
    1. Crinière Lise, Lhommet C, Caille A, Giraudeau Bruno, Lecomte Pierre, Couet Charles, Oppert Jean-Michel, Jacobi David. Reproducibility and validity of the French version of the long international physical activity questionnaire in patients with type 2 diabetes. J Phys Act Health. 2011 Aug;8(6):858–65.
    1. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR, Tudor-Locke C, Greer JL, Vezina J, Whitt-Glover MC, Leon AS. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011 Aug;43(8):1575–81. doi: 10.1249/MSS.0b013e31821ece12.
    1. World HO. Pacific Physical Activity Guidelines for Adults. 2008. [2018-07-23]. .
    1. Hjermstad M, Fossa S, Bjordal K, Kaasa S. Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. J Clin Oncol. 1995 May;13(5):1249–54. doi: 10.1200/JCO.1995.13.5.1249.
    1. Piper B, Dibble S, Dodd M. The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum ? 1998;25:84.
    1. Gledhill J, Rodary C, Mahé Cedric, Laizet Céline. [French validation of the revised Piper Fatigue Scale] Rech Soins Infirm. 2002 Mar;(68):50–65.
    1. Sass C, Moulin J, Guéguen R. Le score EPICES?: un score individuel de précarité. Construction et évaluation du score dans une population de 197 389 personnes. 2006
    1. Labbe E, Blanquet M, Gerbaud L, Poirier G, Sass C, Vendittelli F, Moulin J. A new reliable index to measure individual deprivation: the EPICES score. Eur J Public Health. 2015 Aug;25(4):604–9. doi: 10.1093/eurpub/cku231.
    1. Vallance J, Lavallee C, Culos-Reed N, Trudeau M. Rural and small town breast cancer survivors' preferences for physical activity. Int J Behav Med. 2013 Dec;20(4):522–8. doi: 10.1007/s12529-012-9264-z.
    1. Friedenreich CM, Pialoux V, Wang Q, Shaw E, Brenner DR, Waltz X, Conroy SM, Johnson R, Woolcott CG, Poulin MJ, Courneya KS. Effects of exercise on markers of oxidative stress: an Ancillary analysis of the Alberta Physical Activity and Breast Cancer Prevention Trial. BMJ Open Sport Exerc Med. 2016 Oct;2(1):e000171. doi: 10.1136/bmjsem-2016-000171.
    1. Faёs C, Martin C, Chirico EN, Féasson L, Oyonno-Enguelle S, Dubouchaud H, Francina A, Thiriet P, Pialoux V, Messonnier L. Effect of α-thalassaemia on exercise-induced oxidative stress in sickle cell trait. Acta Physiol (Oxf) 2012 Aug;205(4):541–50. doi: 10.1111/j.1748-1716.2012.02434.x.
    1. Cadmus-Bertram LA, Marcus BH, Patterson RE, Parker BA, Morey BL. Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women. Am J Prev Med. 2015 Sep;49(3):414–8. doi: 10.1016/j.amepre.2015.01.020.
    1. INCa Bénéfices de l?activité physique pendant et après cancer. Des connaissances scientifiques aux repères pratiques. 2017
    1. Tudor-Locke C, Bassett D. How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med. 2004;34(1):1–8.

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