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PeRioperative Optimization With Nutritional Supplements for Patients Undergoing GastRointEStinal Surgery for Cancer (PROGRESS)

1. september 2021 oppdatert av: Pablo Serrano, Hamilton Health Sciences Corporation

PeRioperative Optimization With Nutritional Supplements in Patients Undergoing GastRointEStinal Surgery for Cancer (PROGRESS): A Randomized Placebo Controlled Feasibility Study.

This is a single-center randomized, placebo-controlled, double-blind feasibility study comparing the intervention of perioperative nutritional supplements (immunomodulation, carbohydrate loading, and protein isolate) with an identical placebo for each solution in patients with gastrointestinal cancer undergoing surgery. Eligible and consenting patients will be randomly allocated to receive the intervention or placebo in a 1:1 ratio.

This study will assess the feasibility of a large, multi-centre trial by establishing the feasibility of randomization to intervention or placebo. This study will be conducted at the Juravinski Hospital and will enroll 100 patients over 18 months.

The study intervention includes three perioperative nutritional supplements: (1) a protein supplement administered 3 times a day for 30 days before surgery, (2) a sugar-based supplement administered the day prior to and the day of surgery, and (3) a formulated liquid diet containing arginine, RNA, proteins and omega-6 fatty acids (referred to as immunonutrition for the purposes of this study) administered for 5 days prior to and 5 days after surgery.

The primary outcome for each eligible patient is defined as being randomized to intervention or placebo. The criteria for success of this study is defined as the proportion of eligible patients randomized as ≥ 60%. If the estimated proportion is <40%, the trial will be considered not feasible. If the proportion is between 40%-59%, the trial will be considered feasible with modifications to improve enrolment. Other secondary objectives include compliance with study intervention, estimating differences in postoperative complications, length of hospital stay, and quality of life between groups.

Studieoversikt

Status

Fullført

Forhold

Studietype

Intervensjonell

Registrering (Faktiske)

73

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Ontario
      • Hamilton, Ontario, Canada, L8V1C3
        • Hamilton Health Sciences

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Men and women 18 years of age or older
  • Diagnosed with a resectable type of gastrointestinal cancer (e.g. cancers of the gallbladder, liver, pancreas, stomach, small intestine, colon and rectum) for which an elective operation is planned (resection vs. palliative procedure).
  • Patients with distant metastasis are eligible for the study.
  • Patients who are lactose intolerant are also eligible for the study because the amount of lactose in ISOlution and PreCovery is minimal (trace).

Exclusion Criteria:

  • Malabsorption syndrome (e.g. chronic pancreatitis)
  • Cannot tolerate oral intake (e.g. gastric outlet obstruction or delayed gastric emptying)
  • Organ failure (liver, kidney); end stage liver disease with a Child Pugh Score ≥ B or end stage renal disease defined as stages 3 and 4 with a glomerular filtration rate between 30-59 for stage 3 and 15-29 for stage 4.
  • Inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematous, Crohn's disease and ulcerative colitis
  • Patients currently on steroids
  • Poorly controlled type 1 or 2 diabetes mellitus
  • Female patients who are pregnant and/or lactating
  • Galactosemia
  • Ongoing infection.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Placebo komparator: Placebo
Each placebo is composed of a collagen-based filler with exactly the same taste and texture as the intervention.
Each placebo is composed of a collagen-based filler with exactly the same taste and texture as the intervention.
Eksperimentell: Nutritional Supplements
carbohydrate loading, immunonutrition (formulated liquid diet), protein supplement
PreCovery is a carbohydrate loading nutritional supplement, INergy FLD is an immunonutrition formulated liquid diet, and ISOlution is a protein supplement.
Andre navn:
  • PreCovery
  • INergy FLD
  • ISOlution

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
The number of patients randomized to the study
Tidsramme: 21 months
Feasibility of this study will be determined by the number of eligible patients randomized to intervention or placebo.
21 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
The number of patients who comply with the study intervention regimen
Tidsramme: 30 days before index surgery, and up to 5 days after index surgery
Compliance will be defined as intake of at least 70% of study intervention regimen.
30 days before index surgery, and up to 5 days after index surgery
Overall Complications
Tidsramme: 3 months after index surgery
Occurrence of any postoperative complication (major or minor) from surgery following each patient's hospital stay and up to 90 days from the initial operation. Occurrence of any postoperative infections will also be calculated.
3 months after index surgery
Comprehensive Complication Index
Tidsramme: 3 months after index surgery
At 90 days from the index operation will be determined for each patient. This index can be calculated for each patient using the online calculator www.assessurgery.com25 following the grading of each postoperative complication according to Clavien-Dindo.
3 months after index surgery
Quality of Life (QoL) - EORTC-QLQ-C Instrument
Tidsramme: Baseline, 1 month, and 3 months after index surgery
The global health related QoL at baseline, 1 and 3 months following randomization measured using the EORTC-QLQ-C instrument.
Baseline, 1 month, and 3 months after index surgery
Quality of Life (QoL) - FACT-G Scale
Tidsramme: Baseline, 1 month, and 3 months after index surgery
The global health related QoL at baseline, 1 and 3 months following randomization measured using the FACT-G scale.
Baseline, 1 month, and 3 months after index surgery
Length of Hospital Stay
Tidsramme: 1 month after index surgery
Will be determined for each patient.
1 month after index surgery

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

17. oktober 2018

Primær fullføring (Faktiske)

22. juli 2020

Studiet fullført (Faktiske)

30. august 2020

Datoer for studieregistrering

Først innsendt

21. desember 2017

Først innsendt som oppfylte QC-kriteriene

22. februar 2018

Først lagt ut (Faktiske)

26. februar 2018

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. september 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. september 2021

Sist bekreftet

1. september 2021

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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