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Diabetes Prevention Program (METFIT) in Reducing Insulin Resistance in Stage I-III Breast Cancer Survivors

Primary Purpose

Anatomic Stage I Breast Cancer AJCC v8, Anatomic Stage IA Breast Cancer AJCC v8, Anatomic Stage IB Breast Cancer AJCC v8

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Dietary Intervention
Sponsored by
City of Hope Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Anatomic Stage I Breast Cancer AJCC v8

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Women who have been treated definitively for early stage breast cancer (I-III) and are 60-180 days from completion of chemotherapy, radiation and surgery regardless of hormonal status
  • Demonstrated at least a 10% weight gain since being diagnosed with breast cancer
  • Demonstrated IR by having a Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score of >= 2.0
  • Demonstrated IR manifested by meeting criteria for metabolic equivalent (MetS) as defined by modified criteria of the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) (2005 version) and the World Health Organization (WHO) which includes:

    • Dysregulation of glucose homeostasis demonstrated by a glycosylated hemoglobin (HbA1c) >= 6.5%; OR fasting plasma glucose >= 126 mg/dl (7.0 mmol/L) OR random plasma glucose >= 200 mg/dL (11.1 mmol/L)
    • Plus two of any of the following:

      • Waist circumference in men >= 40 inches and in women >= 35 inches
      • Elevated triglycerides >= 150 mg/dL
      • Low high-density lipoprotein (HDL) cholesterol in men < 40 mg /dL and in women < 50 mg/dL or taking statin medication
      • Elevated blood pressure defined by a systolic pressure >= 130 of a diastolic pressure >= 85 mm Hg or taking anti-hypertensive medication
      • Elevated fasting glucose >= 110 mg/dL
  • Non-smoker (last use 6 months prior to enrollment into the study)
  • Documented informed consent of the participant and/or legally authorized representative
  • Willingness to make substantial changes in their dietary and physical activity behavior
  • Willingness to attend at 70% of the intervention sessions and 100% of the blood draws
  • The effects of IF on the developing fetus of breast cancer survivors are unknown. For this reason, women of child bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for six months following duration of study participation. Should a woman become pregnant or suspect that she is pregnant while participating in the trial, should inform her treating physician immediately
  • Willingness to weigh themselves weekly
  • Willingness to wear a subcutaneous continuous glucose monitor
  • Access to an electronic virtual teleconferencing device and capacity to utilize electronic teleconference technology

Exclusion Criteria:

  • Use of any medication to treat diabetes mellitus
  • Type 2 diabetes
  • History of myocardial infarction or congestive heart failure within the previous 12 months prior to being screened for participation in the study
  • Cardiovascular, respiratory or musculoskeletal disease or joint problems that preclude moderate physical activity
  • Unstable cardiac disease as defined by one of the following:

    • Cardiac events such as myocardial infarction (MI) within the past 6 months
    • New York Heart Association (NYHA) heart failure class III-IV
    • Uncontrolled atrial fibrillation or hypertension
  • History of vascular disease (e.g. deep vein thrombosis, stroke) within six months of starting the intervention
  • Clinically significant uncontrolled illness
  • Women who are pregnant or breastfeeding
  • Any other condition (including psychosocial condition) that would, in the investigator's judgment, contraindicates the patient's participation in the clinical study due to safety concerns with clinical study procedures
  • Any other condition that would confound study results
  • Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Treatment (METFIT program)

    Arm Description

    Patients undergo METFIT program for 16 sessions over 6 months.

    Outcomes

    Primary Outcome Measures

    Fidelity
    The percentage of the cohort that has concordance of glucose trends with diet log to assess adherence to intermittent fasting regimen by week 8 of the intervention. Descriptive quantitative statistics will be used to report fidelity.
    Retention
    Defined as the rate of participants that complete the intervention and post intervention assessments. Attendance percentage of blood draws and body measurements at both time points. Descriptive quantitative statistics will be used to report retention.

    Secondary Outcome Measures

    Change in insulin resistance (IR)
    Assessed by Homeostatic Model Assessment of Insulin Resistance [HOMA-IR]). The HOMA-IR scores of each subject will be compared to their HOMA-IR scores after the intervention using a paired t-test analysis.

    Full Information

    First Posted
    September 10, 2020
    Last Updated
    June 7, 2022
    Sponsor
    City of Hope Medical Center
    Collaborators
    National Cancer Institute (NCI)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04560439
    Brief Title
    Diabetes Prevention Program (METFIT) in Reducing Insulin Resistance in Stage I-III Breast Cancer Survivors
    Official Title
    METFIT Program - A Pilot Study Exploring the Feasibility of a Diabetes Prevention Program (DPP)-Based Lifestyle Modification Intervention to Reduce Insulin Resistance in Breast Cancer Survivors
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Funding
    Study Start Date
    June 15, 2022 (Anticipated)
    Primary Completion Date
    June 15, 2023 (Anticipated)
    Study Completion Date
    June 15, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    City of Hope Medical 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
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This trial studies how well a diabetes prevention program (METFIT) works in reducing insulin resistance in stage I-III breast cancer survivors. METFIT program, a diet and lifestyle intervention, utilizes intermittent fasting to reduce insulin resistance in insulin resistant breast cancer survivors. Intermittent fasting has been shown to have benefits for patients undergoing cancer therapy by improving symptoms such as fatigue in breast cancer patients. Intermittent fasting has also shown potential for decreasing the risk of breast cancer coming back (recurrence). This trial is being done to determine if METFIT program can be successfully and effectively implemented to reduce insulin resistant in breast cancer survivors.
    Detailed Description
    PRIMARY OBJECTIVE: I. To evaluate the feasibility of the METFIT Program - a 6-month modified Diabetes Prevention Program (DPP)-based lifestyle modification intervention that utilizes intermittent fasting (IF) aimed at reducing insulin resistance (IR) in insulin resistant breast cancer survivors. SECONDARY OBJECTIVE: I. To estimate an effect size of the effectiveness of the METFIT Program in reducing IR in insulin resistant breast cancer survivors. OUTLINE: Patients undergo METFIT program for 16 sessions over 6 months. After completion of study treatment, patients are followed up for 40 days.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Anatomic Stage I Breast Cancer AJCC v8, Anatomic Stage IA Breast Cancer AJCC v8, Anatomic Stage IB Breast Cancer AJCC v8, Anatomic Stage II Breast Cancer AJCC v8, Anatomic Stage IIA Breast Cancer AJCC v8, Anatomic Stage IIB Breast Cancer AJCC v8, Anatomic Stage III Breast Cancer AJCC v8, Anatomic Stage IIIA Breast Cancer AJCC v8, Anatomic Stage IIIB Breast Cancer AJCC v8, Anatomic Stage IIIC Breast Cancer AJCC v8, Early-Stage Breast Carcinoma, Prognostic Stage I Breast Cancer AJCC v8, Prognostic Stage IA Breast Cancer AJCC v8, Prognostic Stage IB Breast Cancer AJCC v8, Prognostic Stage II Breast Cancer AJCC v8, Prognostic Stage IIA Breast Cancer AJCC v8, Prognostic Stage IIB Breast Cancer AJCC v8, Prognostic Stage III Breast Cancer AJCC v8, Prognostic Stage IIIA Breast Cancer AJCC v8, Prognostic Stage IIIB Breast Cancer AJCC v8, Prognostic Stage IIIC Breast Cancer AJCC v8

    7. Study Design

    Primary Purpose
    Other
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Treatment (METFIT program)
    Arm Type
    Experimental
    Arm Description
    Patients undergo METFIT program for 16 sessions over 6 months.
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Dietary Intervention
    Other Intervention Name(s)
    Dietary Modification, intervention, dietary, Nutrition Intervention, Nutrition Interventions, Nutritional Interventions
    Intervention Description
    Undergo METFIT program
    Primary Outcome Measure Information:
    Title
    Fidelity
    Description
    The percentage of the cohort that has concordance of glucose trends with diet log to assess adherence to intermittent fasting regimen by week 8 of the intervention. Descriptive quantitative statistics will be used to report fidelity.
    Time Frame
    Up to week 8 of intervention
    Title
    Retention
    Description
    Defined as the rate of participants that complete the intervention and post intervention assessments. Attendance percentage of blood draws and body measurements at both time points. Descriptive quantitative statistics will be used to report retention.
    Time Frame
    Up to 6 months
    Secondary Outcome Measure Information:
    Title
    Change in insulin resistance (IR)
    Description
    Assessed by Homeostatic Model Assessment of Insulin Resistance [HOMA-IR]). The HOMA-IR scores of each subject will be compared to their HOMA-IR scores after the intervention using a paired t-test analysis.
    Time Frame
    Baseline to 6 months

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Women who have been treated definitively for early stage breast cancer (I-III) and are 60-180 days from completion of chemotherapy, radiation and surgery regardless of hormonal status Demonstrated at least a 10% weight gain since being diagnosed with breast cancer Demonstrated IR by having a Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score of >= 2.0 Demonstrated IR manifested by meeting criteria for metabolic equivalent (MetS) as defined by modified criteria of the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) (2005 version) and the World Health Organization (WHO) which includes: Dysregulation of glucose homeostasis demonstrated by a glycosylated hemoglobin (HbA1c) >= 6.5%; OR fasting plasma glucose >= 126 mg/dl (7.0 mmol/L) OR random plasma glucose >= 200 mg/dL (11.1 mmol/L) Plus two of any of the following: Waist circumference in men >= 40 inches and in women >= 35 inches Elevated triglycerides >= 150 mg/dL Low high-density lipoprotein (HDL) cholesterol in men < 40 mg /dL and in women < 50 mg/dL or taking statin medication Elevated blood pressure defined by a systolic pressure >= 130 of a diastolic pressure >= 85 mm Hg or taking anti-hypertensive medication Elevated fasting glucose >= 110 mg/dL Non-smoker (last use 6 months prior to enrollment into the study) Documented informed consent of the participant and/or legally authorized representative Willingness to make substantial changes in their dietary and physical activity behavior Willingness to attend at 70% of the intervention sessions and 100% of the blood draws The effects of IF on the developing fetus of breast cancer survivors are unknown. For this reason, women of child bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for six months following duration of study participation. Should a woman become pregnant or suspect that she is pregnant while participating in the trial, should inform her treating physician immediately Willingness to weigh themselves weekly Willingness to wear a subcutaneous continuous glucose monitor Access to an electronic virtual teleconferencing device and capacity to utilize electronic teleconference technology Exclusion Criteria: Use of any medication to treat diabetes mellitus Type 2 diabetes History of myocardial infarction or congestive heart failure within the previous 12 months prior to being screened for participation in the study Cardiovascular, respiratory or musculoskeletal disease or joint problems that preclude moderate physical activity Unstable cardiac disease as defined by one of the following: Cardiac events such as myocardial infarction (MI) within the past 6 months New York Heart Association (NYHA) heart failure class III-IV Uncontrolled atrial fibrillation or hypertension History of vascular disease (e.g. deep vein thrombosis, stroke) within six months of starting the intervention Clinically significant uncontrolled illness Women who are pregnant or breastfeeding Any other condition (including psychosocial condition) that would, in the investigator's judgment, contraindicates the patient's participation in the clinical study due to safety concerns with clinical study procedures Any other condition that would confound study results Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Raynald Samoa
    Organizational Affiliation
    City of Hope Medical Center
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Diabetes Prevention Program (METFIT) in Reducing Insulin Resistance in Stage I-III Breast Cancer Survivors

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