Individueel Afgestemde, Begeleide, Op Afstand Uitgevoerde Bewegingsinterventie ter Verbetering van de Lichamelijke Functie voor Patiënten met Stadium I-III Slokdarm- en Maagkanker, PRECISE Studie (PRECISE)
Een pilotstudie van een individueel op maat gemaakt, begeleid, op afstand uitgevoerd bewegingsinterventieprogramma om de fysieke functie te verbeteren bij overlevenden van maag- en slokdarmkanker (PRECISE-studie)
This clinical trial tests an individually tailored, supervised, remote exercise intervention to improve physical function for stage I-III gastroesophageal cancer survivors. Modern treatments for gastroesophageal cancer are effective at treating the cancer but are often aggressive, can be difficult for patients to tolerate, and can lead to significant debilitation and a loss of independence. Exercise is one promising intervention that could improve physical function in patients with gastroesophageal cancer after finishing systemic treatment. Home based exercise interventions in patients with cancer during and after chemotherapy can improve fatigue and function. An individually tailored, supervised, remote exercise intervention may improve physical function for stage I-III gastroesophageal cancer survivors.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
- Klinische fase III maagkanker AJCC v8
- Klinische fase III Gastro-oesofageale overgang Adenocarcinoom AJCC v8
- Klinisch stadium I slokdarmplaveiselcelcarcinoom AJCC v8
- Klinische fase I maagkanker AJCC v8
- Klinisch stadium II oesofageaal adenocarcinoom AJCC v8
- Klinisch stadium II slokdarmplaveiselcelcarcinoom AJCC v8
- Klinische fase II maagkanker AJCC v8
- Klinisch stadium III oesofageaal adenocarcinoom AJCC v8
- Klinisch stadium III slokdarmplaveiselcelcarcinoom AJCC v8
- Klinische fase II gastro-oesofageale overgang Adenocarcinoom AJCC v8
- Klinische fase I gastro-oesofageale overgang Adenocarcinoom AJCC v8
- Klinisch stadium I slokdarmadenocarcinoom American Joint Committee on Cancer (AJCC) v8
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
PRIMARY OBJECTIVE:
I. To determine the feasibility of the exercise intervention, as measured by the percentage of participants who attend at least 80% of the exercise sessions and complete the post-intervention functional assessment.
SECONDARY OBJECTIVES:
I. To determine other measures of feasibility of the exercise intervention, including eligibility, recruitment, and achievement of exercise goals.
II. To determine the change in measures of physical function (Short Physical Performance Battery [SPPB], grip strength, Two Minute Step Test [TMST], Activities of Daily Living [ADL], and instrumental ADL) from baseline to end of study.
III. To determine the change in frailty status (Deficit Accumulation Index [DAI]) from baseline to end of study.
IV. To determine the change in measures of cognitive function (Montreal Cognitive Assessment [MOCA] and Patient Reported Outcomes Measurement Information System [PROMIS] Cognitive Function Short Form) from baseline to end of study.
V. To determine the change in anxiety (General Anxiety Disorder-7 [GAD-7]) from baseline to end of study.
VI. To determine the change in depression (Patient Health Questionnaire-8 [PHQ-8]) from baseline to end of study.
VII. To determine the change in sleep quality (Insomnia Severity Index) from baseline to end of study.
VIII. To determine the change in quality of life (Short Form [SF]-36) from baseline to end of study.
IX. To evaluate adverse events (Patient Reported Outcomes version of Common Terminology Criteria for Adverse Events [PRO-CTCAE] and Common Terminology Criteria for Adverse Events [CTCAE] version [v]5.0) during the study intervention.
X. To identify patient perspectives on the whether or not the study intervention was worthwhile.
EXPLORATORY OBJECTIVES:
I. To determine the reliability of using remote monitoring devices to measure functional health in real-time during the study intervention.
II. To determine the change in biomarkers of aging from baseline to end of study.
OUTLINE:
Patients receive access to the Moterum application and complete remotely delivered, supervised exercise sessions, over 1 hour, 3 times per week for 8 weeks. Sessions consist of both aerobic and resistance training exercises. Patients also receive written instructions and videos of strengthening exercises. Patients undergo blood sample collection throughout the study.
After completion of study intervention, patients are followed up at 6 months.
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Jingran Ji, MD
- Telefoonnummer: 310-829-5471
- E-mail: jingranji@mednet.ucla.edu
Studie Locaties
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-
California
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Los Angeles, California, Verenigde Staten, 90095
- Werving
- UCLA / Jonsson Comprehensive Cancer Center
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Contact:
- Jingran Ji, MD
- Telefoonnummer: 310-829-5471
- E-mail: jingranji@mednet.ucla.edu
-
Hoofdonderzoeker:
- Jingran Ji, MD
-
-
Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Adults ≥ 18 years old at the start of study treatment
- Diagnosis of early-stage (Stage I, II, III) esophageal, gastroesophageal junction, or gastric cancer. Histology can be adenocarcinoma, squamous cell carcinoma, or poorly differentiated carcinoma
- Treated with at least one systemic therapy (chemotherapy or immunotherapy) and within 12 months of completing curative intent gastroesophageal cancer (GEC) treatment
- Have evidence of physical function impairment, defined as a SPPB score of < 12) at baseline
- Ability to understand English and the willingness to sign a written informed consent document
Exclusion Criteria:
- Patients with stage I disease who underwent endoscopic resection or surgery alone without perioperative systemic therapy
- Patients with stage IV disease or unresectable locally advanced disease taking a palliative treatment approach without a clearly defined end of treatment
- Patients currently receiving ongoing systemic therapy for GEC or another malignancy
- Patients who are unable to provide informed consent
- Any other condition or pre-existing co-morbidity that would, in the Investigator's judgment, contraindicate the participation in the study due to safety concerns with study procedures
- Currently participating in another exercise intervention research study seeking to improve functional status, alleviate frailty, muscle strength, exhaustion/fatigue, or cognitive function
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Experimenteel: Supportive care (Remote exercise intervention)
Patients receive access to the Moterum application and complete remotely delivered, supervised exercise sessions, over 1 hour, 3 times per week for 8 weeks. Sessions consist of both aerobic and resistance training exercises. Patients also receive written instructions and videos of strengthening exercises. Patients undergo blood sample collection throughout the study. |
Undergo blood sample collection
Andere namen:
Ancillary studies Ancillary studies Ancillary studies Receive written instructions
Andere namen:
Receive videos of strengthening exercises
Andere namen:
Compete exercise sessions Receive access to Moterum application Ancillary studies
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Percentage of participants who attend at least 80% of the exercise sessions and complete the post-intervention functional assessment
Tijdsspanne: At 8 weeks
|
Will use descriptive statistics to summarize the participant population, feasibility metrics, and safety data. The study will be deemed feasible if > 60% (12 or more) of the 20 enrolled participants are retained. |
At 8 weeks
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Percentage patiënten die gescreend worden en in aanmerking komen voor de interventie
Tijdsspanne: Tot 16 maanden
|
Tot 16 maanden
|
|
|
Percentage van in aanmerking komende patiënten die instemmen met deelname aan de interventie
Tijdsspanne: Tot '6 maanden
|
Tot '6 maanden
|
|
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Percentage van de in aanmerking komende deelnemers die aan het einde van de studieperiode de duur- en intensiteitsdoelen voor de aerobe en weerstandsoefeningen halen
Tijdsspanne: Tot 8 weken
|
Tot 8 weken
|
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Change in physical function
Tijdsspanne: From baseline to 8 weeks
|
Assessed via Short Physical Performance Battery. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. |
From baseline to 8 weeks
|
|
Change in grip strength
Tijdsspanne: From baseline to 8 weeks
|
Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. |
From baseline to 8 weeks
|
|
Change in physical function
Tijdsspanne: From baseline to 8 weeks
|
Assessed via the two minute step test. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The two-minute step test is administered by measuring the midpoint of the participant's patella and the top of their iliac crest and measuring how many times the participant's right knee can reach this point while marching in place for 2 minutes. A higher step count means a better outcome. |
From baseline to 8 weeks
|
|
Change in activities of daily living
Tijdsspanne: From baseline to 8 weeks
|
Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The activities of daily living assessment is a calculated from the physical component score of the Short Form-36 health survey. This section consists of 10 items that assess different physical activity domains. Each item has a specific response scale which corresponds to a number. These numbers are summed and transformed into a 0-100 scale, where 0 indicates the worst health and 100 indicates the best health. |
From baseline to 8 weeks
|
|
Change in instrumental activities of daily living
Tijdsspanne: From baseline to 8 weeks
|
Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The instrumental activities of daily living assessment is a 10 items survey that assess different physical activity domains. Each item will be rated and scored based on responses denoting level of limitation (a lot, a little, not at all). The total score ranges from 0 to 100 and higher scores means a better outcome. |
From baseline to 8 weeks
|
|
Change in frailty status
Tijdsspanne: From baseline to 6 months
|
Assessed via Deficit Accumulation Index. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The Deficit Accumulation Index (DAI) is a 50-item frailty index that is derived from the Cancer and Aging Research Group geriatric assessment. The DAI evaluates deficits in multiple geriatric assessment domains. Scores range from 0-1 with a score of 0.0 representing no detected deficits and 1.0 representing the maximum deficit. Based on the score, participants will be categorized into three categories of health status: robust, prefrail, or frail. |
From baseline to 6 months
|
|
Change in cognitive function
Tijdsspanne: From baseline to 6 months
|
Assessed via Montreal Cognitive Assessment. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The Montreal Cognitive Assessment (MoCA) test is a series of questions and assessments to measure eight domains of cognitive function. The MoCA is score from 0-30 with lower scores indicating worse cognitive impairment. A score of <25 suggests some degree of cognitive impairment. |
From baseline to 6 months
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|
Change in cognitive function
Tijdsspanne: From baseline to 6 months
|
Assessed via Patient Reported Outcomes Measurement Information System Cognitive Function Short Form. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The PROMIS Short Form v2.0 - Cognitive Function Short Form 8a provides a self-reported measure of cognitive function consisting of 8 items. Each item includes a statement related to cognitive function that the patient would rate with an attribution (very often (several times a day), often (about once a day), sometimes (two or three times), rarely (once), never) that ranges from 0-5. The items will be summed to obtain a composite score from 0-40 and higher scores indicate better cognitive function. |
From baseline to 6 months
|
|
Change in quality of life
Tijdsspanne: From baseline to 6 months
|
Assessed via 36-Item Short Form Survey. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The 36-Item Short Form Health Survey (SF-36) is a composite measure of quality of life that includes 36 items related to physical (10 items) and social functioning (2 items), pain (2 items), role limitations due to physical health (4 items) and emotional problems (3 items), energy/fatigue (4 items), emotional well-being (5 items), and health perceptions (6 items). Each item is scored on a 0 to 100 range, in which a high score represents a more favorable health state. |
From baseline to 6 months
|
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Change in sleep quality
Tijdsspanne: From baseline to 6 months
|
Assessed via Insomnia Severity Index. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The Insomnia Severity Index is a self-rated questionnaire that assesses sleep problems over a 2-week time interval. Higher scores indicate more acute symptoms of insomnia (no clinically significant insomnia [0-7], subthreshold insomnia [8-14], moderate clinical insomnia [15-21], severe clinical insomnia [22-28]). |
From baseline to 6 months
|
|
Change in anxiety
Tijdsspanne: From baseline to 6 months
|
Assessed via General Anxiety Disorder-7. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The General Anxiety Disorder-7 is a 7-item questionnaire that assesses anxiety severity over a 2-week time interval. This is calculated by assigning scores of 0 (not at all), 1 (several days), 2 (more than half the days), and 3 (nearly every day) to each response. GAD-7 total score for the 7 items ranges from 0 to 21 with higher scores indicating more anxiety (minimal anxiety [0-4], mild anxiety [5-9], moderate anxiety [10-14], severe anxiety [15-21]). |
From baseline to 6 months
|
|
Change in depression
Tijdsspanne: From baseline to 6 months
|
Assessed via Patient Health Questionnaire-8. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. The Patient Health Questionnaire-8 is an 8-item questionnaire that assesses depression over a 2-week time interval. This is calculated by assigning scores of 0 (not at all), 1 (several days), 2 (more than half the days), and 3 (nearly every day) to each response. Higher scores indicate a higher likelihood of clinical depression. |
From baseline to 6 months
|
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Incidence of adverse events
Tijdsspanne: Up to 8 weeks
|
Assessed via National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Will be determined at each time point per patient as the presence (yes/no) of toxicities of grade ≥ 2. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. Adverse Events (AEs) experienced will be captured as defined by the NCI Common Terminology Criteria for Adverse Events (NCI CTCAE v5.0). After grading, each AE will be assigned an attribution by the treating clinician (unlikely, possibly, probably, or definitely related to study agent). |
Up to 8 weeks
|
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Incidence of patient reported adverse events
Tijdsspanne: Up to 8 weeks
|
Assessed via Patient Reported Outcomes version of CTCAE. Will perform exploratory statistical comparisons between baseline and end of study endpoints using t-tests and Fisher exact tests to explore the efficacy of the exercise intervention. Patient-reported Adverse Events (PRO-CTCAE) is a patient-reported outcome measurement system developed to evaluate symptomatic toxicity in patients on cancer clinical trials. Each item is scored 0-4 with higher scores indicated more severe symptoms. No total score is calculated. |
Up to 8 weeks
|
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Patient perspectives on whether or not the study intervention was worthwhile
Tijdsspanne: At 8 weeks
|
Assessed via Was it Worth It (WIWI) questionnaire. Will use descriptive statistics to summarize the proportion of participants who answer 'yes,' 'uncertain,' and 'no' to the items in the WIWI Questionnaire and compare responses between participants with improvement in physical function and those without, bivariately and multivariately controlling for other factors. |
At 8 weeks
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Jingran Ji, MD, UCLA / Jonsson Comprehensive Cancer Center
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Onderzoekstechnieken
- Klinische laboratoriumtechnieken
- Diagnostische technieken en procedures
- Diagnose
- Gezondheidsdiensten
- Gezondheidszorgfaciliteiten personeel en diensten
- Child Health Services
- Community Health Services
- Preventieve gezondheidsdiensten
- Sociaaleconomische factoren
- Bevolkingskenmerken
- Diagnostische technieken, ademhalingssysteem
- Diagnostische technieken, cardiovasculair
- Hartfunctietests
- Ademhalingsfunctietests
- Ergometrie
- Monitoring, fysiologisch
- Versnellingsbak
- Methoden
- Vroege interventie, educatief
- Educatieve status
- Exemplaarbehandeling
- Trainingstest
- Actigrafie
Andere studie-ID-nummers
Andere studie-ID-nummers
- 25-0954
- NCI-2026-00630 (Register-ID: CTRP (Clinical Trial Reporting Program))
Informatie over medicijnen en apparaten, studiedocumenten
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product vervaardigd in en geëxporteerd uit de V.S.
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