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Exercise Therapy to Improve Cardiovascular Health in Post-Menopausal Women After Treatment for Early Stage Breast Cancer

Primary Purpose

Early Stage Breast Cancer

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Aerobic Training
Aerobic Training
Aerobic Training
Aerobic Training
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Early Stage Breast Cancer focused on measuring Exercise Therapy, Aerobic Training, Post-Menopausal Women, 20-130

Eligibility Criteria

21 Years - 80 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Aged 21-80 years
  • Female
  • Surgically resected early stage (I-III) primary breast cancer
  • Post-menopausal, defined as one of the following:

    • Age ≥ 45 with no menses for at least 2 years
    • Chemically and/or surgically induced menopause through ovarian suppression, as determined by the primary oncologist
    • Estradiol level of ≤30 pg/mL
  • An interval of at least one year, but no more than five years, following the full completion of definitive therapy for malignant disease. Definitive therapy is defined as:

    • Surgery plus radiation
    • Surgery plus chemotherapy
    • Surgery plus trastuzumab
  • Exercise intolerance (i.e., patients must have a VO2peak below that predicted for active age and sex-matched individuals. Note: Normative values are available up to 80 years of age)
  • Able to complete an acceptable baseline CPET, in the absence of high-risk ECG findings or other inappropriate response to exercise as determined by the PI, as defined by any of the following criteria:

    • Achieving a plateau in oxygen consumption, concurrent with an increase in power output;
    • A respiratory exchange ratio ≥ 1.10;
    • Attainment of maximal predicted heart rate (HRmax) (i.e., within 10 bpm of age-predicted HRmax [HRmax = 220-Age[years]);
    • Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale
  • Willingness to comply with all study-related procedures.

Exclusion Criteria:

  • Any of the following absolute contraindications to cardiopulmonary exercise testing:

    • Acute myocardial infarction within 3-5 days of any planned study procedures
    • Unstable angina
    • Uncontrolled arrhythmia causing symptoms or hemodynamic compromise
    • Recurrent syncope
    • Active endocarditis
    • Acute myocarditis or pericarditis
    • Symptomatic severe aortic stenosis
    • Uncontrolled heart failure
    • Acute pulmonary embolus or pulmonary infarction within 3 months of any planned study procedures
    • Thrombosis of lower extremities
    • Suspected dissecting aneurysm
    • Uncontrolled asthma
    • Pulmonary edema
    • Respiratory failure
    • Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (e.g., infection, renal failure, thyrotoxicosis)
  • Presence of any other concurrent, actively treated malignancy
  • History of any other malignancy treated within the past 3 years (other than non-melanoma skin cancer)
  • Presence of distant metastatic disease (i.e., stage IV)
  • Room air desaturation at rest ≤ 85%
  • Mental impairment leading to inability to cooperate.
  • Any other condition or intercurrent illness that, in the opinion of the investigator, makes the participant a poor candidate for the trial.

Sites / Locations

  • Hartford Healthcare Cancer Institute @ Hartford Hospital (Data Collection Only)Recruiting
  • Memorial Sloan Kettering Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Active Comparator

Arm Label

(A) breast cancer after completion of chemo

(B) breast cancer after completion of chemo

(C) breast cancer after completion of chemo

(D) breast cancer after completion of chemo

Arm Description

300 min/wk for 16 weeks, followed by 16 weeks of usual care.

150 min/wk for 32 weeks.

300 min/wk for 32 weeks.

150 min/wk for 16 weeks, followed by 16 weeks of usual care.

Outcomes

Primary Outcome Measures

peak oxygen consumption (VO2peak; ml O2.kg-1.min) response rate
A CRF change ≥1.32 ml O2.kg-1.min-1 will be considered a response; a change <1.32 ml O2.kg-1.min-1 will be considered a non-response.

Secondary Outcome Measures

Full Information

First Posted
July 2, 2020
Last Updated
July 31, 2023
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT04458532
Brief Title
Exercise Therapy to Improve Cardiovascular Health in Post-Menopausal Women After Treatment for Early Stage Breast Cancer
Official Title
A Randomized Trial to Minimize Non-Response to Aerobic Training in Post-Menopausal Women With Early Stage Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 8, 2020 (Actual)
Primary Completion Date
July 2025 (Anticipated)
Study Completion Date
July 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This study will compare the effects on cardiorespiratory fitness (CRF) of aerobic exercise in different amounts (number of minutes/session) over different periods of time (number of weeks). Aerobic exercise is physical activity of light-to-moderate intensity that uses the large muscle groups (muscles in your legs, buttocks, back, and chest) and can be performed for at least 10 minutes. The researchers will study the effects of different exercise programs on how well the study participants' bodies use oxygen, how well their heart pumps blood, how well their lungs function, and how healthy their blood vessels are.
Detailed Description
Prior to the initiation of every supervised aerobic training session, patient resting vital signs will be assessed to ensure the patient can safely proceed with the session. Vital signs, including resting heart rate and blood pressure, will be collected and monitored per ExOnc program guidelines. In addition, the planned session will not be initiated if the ExOnc staff member observes any concerns that may compromise participant safety and/or the integrity of the planned session. Vital sign monitoring guidelines for unsupervised sessions, prescribed at lower intensities, will be advised by the exercise physiologist at the time the session plan is provided to the patient. Patients will be instructed to not begin an unsupervised session if their resting heart rate or blood pressure is outside the recommended guidelines.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Early Stage Breast Cancer
Keywords
Exercise Therapy, Aerobic Training, Post-Menopausal Women, 20-130

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
This is a single-center randomized controlled trial (RCT) study designed to evaluate the cardiorespiratory fitness (CRF) response rate to different aerobic therapy (AT) doses in patients with post-treatment primary breast cancer.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
152 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
(A) breast cancer after completion of chemo
Arm Type
Experimental
Arm Description
300 min/wk for 16 weeks, followed by 16 weeks of usual care.
Arm Title
(B) breast cancer after completion of chemo
Arm Type
Experimental
Arm Description
150 min/wk for 32 weeks.
Arm Title
(C) breast cancer after completion of chemo
Arm Type
Experimental
Arm Description
300 min/wk for 32 weeks.
Arm Title
(D) breast cancer after completion of chemo
Arm Type
Active Comparator
Arm Description
150 min/wk for 16 weeks, followed by 16 weeks of usual care.
Intervention Type
Other
Intervention Name(s)
Aerobic Training
Intervention Description
300 min/wk for 16 weeks
Intervention Type
Other
Intervention Name(s)
Aerobic Training
Intervention Description
150 min/wk for 32 weeks
Intervention Type
Other
Intervention Name(s)
Aerobic Training
Intervention Description
300 min/wk for 32 weeks
Intervention Type
Other
Intervention Name(s)
Aerobic Training
Intervention Description
150 min/wk for 16 weeks
Primary Outcome Measure Information:
Title
peak oxygen consumption (VO2peak; ml O2.kg-1.min) response rate
Description
A CRF change ≥1.32 ml O2.kg-1.min-1 will be considered a response; a change <1.32 ml O2.kg-1.min-1 will be considered a non-response.
Time Frame
32 weeks

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
Post-Menopausal Women After Treatment for Early Stage Breast Cancer
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 21-80 years Female Surgically resected early stage (I-III) primary breast cancer Post-menopausal, defined as one of the following: Age ≥ 45 with no menses for at least 2 years Chemically and/or surgically induced menopause through ovarian suppression, as determined by the primary oncologist Estradiol level of ≤30 pg/mL An interval of at least one year, but no more than five years, following the full completion of definitive therapy for malignant disease. Definitive therapy is defined as: Surgery plus radiation Surgery plus chemotherapy Surgery plus trastuzumab Exercise intolerance (i.e., patients must have a VO2peak below the predicted for active age and sex-matched individuals. (+/- the technical error of 1.32 mL/kg/min)]. Note: Normative values are available up to 80 years of age) Able to complete an acceptable baseline CPET, in the absence of high-risk ECG findings or other inappropriate response to exercise as determined by the PI, as defined by any of the following criteria: Achieving a plateau in oxygen consumption, concurrent with an increase in power output; A respiratory exchange ratio ≥ 1.10; Attainment of maximal predicted heart rate (HRmax) (i.e., within 10 bpm of age-predicted HRmax [HRmax = 220-Age[years]); Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale Willingness to comply with all study-related procedures. Exclusion Criteria: Any of the following absolute contraindications to cardiopulmonary exercise testing: Acute myocardial infarction within 3-5 days of any planned study procedures Unstable angina Uncontrolled arrhythmia causing symptoms or hemodynamic compromise Recurrent syncope Active endocarditis Acute myocarditis or pericarditis Symptomatic severe aortic stenosis Uncontrolled heart failure Acute pulmonary embolus or pulmonary infarction within 3 months of any planned study procedures Thrombosis of lower extremities Suspected dissecting aneurysm Uncontrolled asthma Pulmonary edema Respiratory failure Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (e.g., infection, renal failure, thyrotoxicosis) Presence of any other concurrent, actively treated malignancy History of any other malignancy treated within the past 3 years (other than non-melanoma skin cancer) Presence of distant metastatic disease (i.e., stage IV) Room air desaturation at rest ≤ 85% Mental impairment leading to inability to cooperate. Any other condition or intercurrent illness that, in the opinion of the investigator, makes the participant a poor candidate for the trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jessica Scott, PhD
Phone
646-888-8103
Email
scottj1@mskcc.org
First Name & Middle Initial & Last Name or Official Title & Degree
Lee Jones, PhD
Phone
646-888-8103
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jessica Scott, PhD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hartford Healthcare Cancer Institute @ Hartford Hospital (Data Collection Only)
City
Hartford
State/Province
Connecticut
ZIP/Postal Code
06102
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andrew Salner, MD
Phone
860-972-2803
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jessica Scott, PhD
Phone
646-888-8103
First Name & Middle Initial & Last Name & Degree
Lee Jones, PhD
Phone
646-888-8103
First Name & Middle Initial & Last Name & Degree
Jessica Scott, PhD

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Memorial Sloan Kettering Cancer Center supports the international committee of medical journal editors (ICMJE) and the ethical obligation of responsible sharing of data from clinical trials. The protocol summary, a statistical summary, and informed consent form will be made available on clinicaltrials.gov when required as a condition of Federal awards, other agreements supporting the research and/or as otherwise required. Requests for deidentified individual participant data can be made beginning 12 months after publication and for up to 36 months post publication. Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals. Requests may be made to: crdatashare@mskcc.org.
Links:
URL
http://www.mskcc.org/mskcc/html/44.cfm
Description
Memorial Sloan Kettering Cancer Center

Learn more about this trial

Exercise Therapy to Improve Cardiovascular Health in Post-Menopausal Women After Treatment for Early Stage Breast Cancer

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