PeRioperative Optimization With Nutritional Supplements for Patients Undergoing GastRointEStinal Surgery for Cancer (PROGRESS)
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.
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Studietyp
Studietyp
Inskrivning (Faktisk)
Inskrivning
Fas
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
-
-
Ontario
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Hamilton, Ontario, Kanada, L8V1C3
- Hamilton Health Sciences
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-
Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Förebyggande
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Fyrdubbla
Antal vapen
Vapen och interventioner
Deltagargrupp / ArmDeltagargrupp / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Placebo-jämförare: Placebo
Each placebo is composed of a collagen-based filler with exactly the same taste and texture as the intervention.
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Each placebo is composed of a collagen-based filler with exactly the same taste and texture as the intervention.
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Experimentell: Nutritional Supplements
carbohydrate loading, immunonutrition (formulated liquid diet), protein supplement
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PreCovery is a carbohydrate loading nutritional supplement, INergy FLD is an immunonutrition formulated liquid diet, and ISOlution is a protein supplement.
Andra namn:
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Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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The number of patients randomized to the study
Tidsram: 21 months
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Feasibility of this study will be determined by the number of eligible patients randomized to intervention or placebo.
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21 months
|
Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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The number of patients who comply with the study intervention regimen
Tidsram: 30 days before index surgery, and up to 5 days after index surgery
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Compliance will be defined as intake of at least 70% of study intervention regimen.
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30 days before index surgery, and up to 5 days after index surgery
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Overall Complications
Tidsram: 3 months after index surgery
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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.
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3 months after index surgery
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Comprehensive Complication Index
Tidsram: 3 months after index surgery
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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.
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3 months after index surgery
|
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Quality of Life (QoL) - EORTC-QLQ-C Instrument
Tidsram: Baseline, 1 month, and 3 months after index surgery
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The global health related QoL at baseline, 1 and 3 months following randomization measured using the EORTC-QLQ-C instrument.
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Baseline, 1 month, and 3 months after index surgery
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Quality of Life (QoL) - FACT-G Scale
Tidsram: Baseline, 1 month, and 3 months after index surgery
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The global health related QoL at baseline, 1 and 3 months following randomization measured using the FACT-G scale.
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Baseline, 1 month, and 3 months after index surgery
|
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Length of Hospital Stay
Tidsram: 1 month after index surgery
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Will be determined for each patient.
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1 month after index surgery
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Samarbetspartners och utredare
Sponsor
Sponsor
Publikationer och användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Studiestart
Primärt slutförande (Faktisk)
Primärt slutförande
Avslutad studie (Faktisk)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
Andra studie-ID-nummer
- 3988
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