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Effect of Low Intensity Vibration (LIV) on Aromatase Inhibitor- Induced Musculoskeletal Dysfunction in Early Stage Breast Cancer Survivors

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Macrodyne LivMD plate
Sponsored by
Indiana University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Breast Cancer focused on measuring aromatase inhibitors, low intensity vibration

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age ≥ 18 years
  2. Diagnosis of DCIS or stage I, II, or III breast cancer 3 Planned to initiate an AI

    1. Post- menopausal defined as ≥ 60 years of age, prior bilateral oophorectomy, or age over 50 and absence of any menstrual periods in the last 12 months, or FSH and estradiol in the menopausal range
    2. Premenopausal patients receiving chemical ovarian suppression are allowed
    3. Prior aromatase inhibitor use (if this is a second primary, for example) is allowed as long as it has been more than 12 months
    4. Prior tamoxifen is allowed if switching to an aromatase inhibitor, as long as it has been 28 days between last tamoxifen dose and the baseline procedures (per the half-life of tamoxifen)

4. Completion of all primary therapy for breast cancer, including surgery, radiation, and chemotherapy. Patients must be ≥ 21 days from chemotherapy completion and ≥14 days from radiation completion. Ongoing HER2 targeted therapy with trastuzumab or pertuzumab, or TDM1 is allowed. Neratinib, immunotherapy, or CDK4/6 inhibitor therapy is not allowed.

5. Baseline T score > - 2.5 on DXA 6. Body weight less than 275 lbs., as dictated by the weight limit for the LIV platforms 7. ECOG performance status of 0-2 at the time of study enrollment 8. Informed consent and authorization of the release of health information must be obtained according to institutional guidelines 9. Physically able to stand unassisted for 10 minutes at a time 10. Currently not participating in regular exercise (defined as less than 90 minutes of moderate to vigorous exercise per week measured by the RPAQ questionnaire)

Exclusion Criteria:

  1. Unwilling to co-enroll onto the companion FIT core study (IRB study #1707550885)
  2. Diagnosis of other disorder affecting bone function or turnover, such as Paget's disease, renal osteodystrophy, parathyroid disorders, vitamin D deficiency/osteomalacia, chronic renal disease (Cr > 1.4)

    a. Vitamin D will be checked during screening. Patients with Vit D < 20 can be enrolled if supplementation is initiated per the treating physician.

  3. Prior history of non-traumatic, fragility bone fracture
  4. Any muscle or neuromuscular disorder affecting muscle function, such as muscular dystrophy, myositis, or amyotrophic lateral sclerosis
  5. Use of bisphosphonates or denosumab within the prior 12 months
  6. History of retinal detachment
  7. Current or planned pacemaker
  8. Current or planned cochlear implant
  9. Any condition precluding power protocol participation (i.e. riding a stationary bicycle), including: NYHA class III or IV congestive heart failure, uncontrolled angina, myocardial infarction in the prior 12 months, orthopedic surgery in the previous 6 months or plans for orthopedic surgery during the study period, chronic uncontrolled pulmonary conditions such as uncontrolled asthma (symptoms > 2 days/week) or dyspnea requiring oxygen, symptomatic peripheral vascular disease, or any other comorbidity that would interfere with the ability to complete and comply with the protocol in the opinion of the investigator
  10. Metastatic breast cancer

    a. History of prior treated malignancies, other than breast cancer, that are now stable, are in remission, and do not require active therapy, are acceptable.

  11. Patients requiring chronic anticoagulation are excluded from participation in the optional muscle biopsy collection.

Sites / Locations

  • Indiana University Melvin & Bren Simon Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Macrodyne LivMD plate

Wait-Listed Control

Arm Description

Outcomes

Primary Outcome Measures

Mean change in energetic capacity measured by peak power generation on a stationary bicycle
Peak power will be measured using the Power Protocol-B

Secondary Outcome Measures

Change in muscle contractile properties including peak power, fatigue resistance, and time to recovery measured by isokinetic knee extension
A Biodex 4 system will be used to measure each subject's muscle contractile properties
Change in lean body mass
Lean mass, total adiposity measured by DXA scan
Change in bone mineral density of the lumbar spine by T score
Bone mineral density (T score) measured by DXA scan
Change in trabecular and cortical volumetric bone mineral density
By high resolution peripheral quantitative CT of the distal and diaphyseal tibia and radius
Change in serologic bone markers of bone turnover (TGF-beta and NTX) by quantitative measurements using ELISA
TGF-beta and NTX by quantitative measurements using ELISA
Patient reported fatigue measured by the Basic Fatigue Inventory score
Average of all 9 items ranging in a score of 0-10 (total possible score of 11) scores range from 1( no fatigue/does not interfere) to 10 (as bad as you can imagine/completely interferes)
Patient reported aching muscles and joint pain measured by NCI Patient Reported Outcomes-Common Terminology Criteria for Adverse Events score
Average of 2 scale items for aching muscles and joint pain on a 5-point Likert scale (ranging in severity) with a total possible score of 5 (i.e. very severe/ almost constantly)
Feasibility of low intensity vibration defined by patient compliance
Patients will be asked by the study nurse how they are doing with their LIV therapy

Full Information

First Posted
October 16, 2018
Last Updated
September 11, 2023
Sponsor
Indiana University
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1. Study Identification

Unique Protocol Identification Number
NCT03712813
Brief Title
Effect of Low Intensity Vibration (LIV) on Aromatase Inhibitor- Induced Musculoskeletal Dysfunction in Early Stage Breast Cancer Survivors
Official Title
Effect of Low Intensity Vibration (LIV) on Aromatase Inhibitor- Induced Musculoskeletal Dysfunction in Early Stage Breast Cancer Survivors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 2, 2019 (Actual)
Primary Completion Date
September 2024 (Anticipated)
Study Completion Date
September 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Indiana University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to compare the effect of low intensity vibration (LIV) delivered for 10 minutes twice daily for 12 months on skeletal muscle function, in terms of energetic capacity measured by power generation on a stationary bicycle, among patients with early stage breast cancer planned to initiate aromatase inhibitor therapy who do not currently participate in regular exercise, compared to a wait- listed control.
Detailed Description
This is a randomized phase II, two arm, single-center study designed to compare the effect of LIV versus wait-list control on the clinical parameter of energetic capacity, or power generation, in patients with early stage breast cancer receiving aromatase inhibitor therapy over a 12-month period. The primary endpoint is the 12-month change in energetic capacity since baseline. Primary Objective To compare the effect of LIV delivered for 10 minutes twice daily for 12 months on skeletal muscle function, in terms of energetic capacity measured by power generation on a stationary bicycle, among patients with early stage breast cancer planned to initiate aromatase inhibitor therapy who do not currently participate in regular exercise, compared to a wait- listed control Secondary Objectives To compare the effect of LIV versus wait-listed control upon muscle contractile properties including peak power, fatigue resistance, and recovery, measured by isokinetic knee extension To compare the effect of LIV versus wait- listed control upon body composition (lean mass, total adiposity) measured by DXA scan To compare the effect of LIV versus wait- listed control upon bone mineral density (T score) measured by DXA scan To compare the effect of LIV versus wait- listed control upon muscle adipose infiltration measured by muscle density on peripheral quantitative CT imaging of the proximal and distal tibia and radius To compare the effect of LIV versus wait-listed control on trabecular and cortical volumetric bone mineral density by high resolution peripheral quantitative CT of the distal and diaphyseal tibia and radius To compare the effect of LIV versus wait- listed control on serologic markers of bone turnover, including TGF-beta and NTX To compare the effect of LIV versus wait- listed controls upon patient reported outcome measures of fatigue (measured by the Basic Fatigue Inventory), muscle ache, and joint pain (measured by PRO-CTCAE) To describe the feasibility of LIV in this patient population, defined by patient compliance and follow up with the intervention

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
aromatase inhibitors, low intensity vibration

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Patients will be randomized in a 1:1 ratio to LIV or the standard of care. The total patient enrollment will be 72 patients with 36 patients in each arm. Upon registration, subjects will be randomized and given an automated sequence number.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
72 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Macrodyne LivMD plate
Arm Type
Experimental
Arm Title
Wait-Listed Control
Arm Type
No Intervention
Intervention Type
Device
Intervention Name(s)
Macrodyne LivMD plate
Intervention Description
Synchronous (applied to both feet) low intensity vibration for 10 minutes, twice daily for 12 months.
Primary Outcome Measure Information:
Title
Mean change in energetic capacity measured by peak power generation on a stationary bicycle
Description
Peak power will be measured using the Power Protocol-B
Time Frame
Baseline, 6 months, and 12 months
Secondary Outcome Measure Information:
Title
Change in muscle contractile properties including peak power, fatigue resistance, and time to recovery measured by isokinetic knee extension
Description
A Biodex 4 system will be used to measure each subject's muscle contractile properties
Time Frame
Baseline, 6 months, and 12 months
Title
Change in lean body mass
Description
Lean mass, total adiposity measured by DXA scan
Time Frame
Baseline, 6 months, and 12 months
Title
Change in bone mineral density of the lumbar spine by T score
Description
Bone mineral density (T score) measured by DXA scan
Time Frame
Baseline, 6 months, and 12 months
Title
Change in trabecular and cortical volumetric bone mineral density
Description
By high resolution peripheral quantitative CT of the distal and diaphyseal tibia and radius
Time Frame
Baseline and 12 months
Title
Change in serologic bone markers of bone turnover (TGF-beta and NTX) by quantitative measurements using ELISA
Description
TGF-beta and NTX by quantitative measurements using ELISA
Time Frame
Baseline and 12 months
Title
Patient reported fatigue measured by the Basic Fatigue Inventory score
Description
Average of all 9 items ranging in a score of 0-10 (total possible score of 11) scores range from 1( no fatigue/does not interfere) to 10 (as bad as you can imagine/completely interferes)
Time Frame
Baseline, 6 months, and 12 months
Title
Patient reported aching muscles and joint pain measured by NCI Patient Reported Outcomes-Common Terminology Criteria for Adverse Events score
Description
Average of 2 scale items for aching muscles and joint pain on a 5-point Likert scale (ranging in severity) with a total possible score of 5 (i.e. very severe/ almost constantly)
Time Frame
Baseline, 6 months, and 12 months
Title
Feasibility of low intensity vibration defined by patient compliance
Description
Patients will be asked by the study nurse how they are doing with their LIV therapy
Time Frame
Once monthly from Baseline to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Diagnosis of DCIS or stage I, II, or III breast cancer 3 Planned to initiate an AI Post- menopausal defined as ≥ 60 years of age, prior bilateral oophorectomy, or age over 50 and absence of any menstrual periods in the last 12 months, or FSH and estradiol in the menopausal range Premenopausal patients receiving chemical ovarian suppression are allowed Prior aromatase inhibitor use (if this is a second primary, for example) is allowed as long as it has been more than 12 months Prior tamoxifen is allowed if switching to an aromatase inhibitor, as long as it has been 28 days between last tamoxifen dose and the baseline procedures (per the half-life of tamoxifen) 4. Completion of all primary therapy for breast cancer, including surgery, radiation, and chemotherapy. Patients must be ≥ 21 days from chemotherapy completion and ≥14 days from radiation completion. Ongoing HER2 targeted therapy with trastuzumab or pertuzumab, or TDM1 is allowed. Neratinib, immunotherapy, or CDK4/6 inhibitor therapy is not allowed. 5. Baseline T score > - 2.5 on DXA 6. Body weight less than 275 lbs., as dictated by the weight limit for the LIV platforms 7. ECOG performance status of 0-2 at the time of study enrollment 8. Informed consent and authorization of the release of health information must be obtained according to institutional guidelines 9. Physically able to stand unassisted for 10 minutes at a time 10. Currently not participating in regular exercise (defined as less than 90 minutes of moderate to vigorous exercise per week measured by the RPAQ questionnaire) Exclusion Criteria: Unwilling to co-enroll onto the companion FIT core study (IRB study #1707550885) Diagnosis of other disorder affecting bone function or turnover, such as Paget's disease, renal osteodystrophy, parathyroid disorders, vitamin D deficiency/osteomalacia, chronic renal disease (Cr > 1.4) a. Vitamin D will be checked during screening. Patients with Vit D < 20 can be enrolled if supplementation is initiated per the treating physician. Prior history of non-traumatic, fragility bone fracture Any muscle or neuromuscular disorder affecting muscle function, such as muscular dystrophy, myositis, or amyotrophic lateral sclerosis Use of bisphosphonates or denosumab within the prior 12 months History of retinal detachment Current or planned pacemaker Current or planned cochlear implant Any condition precluding power protocol participation (i.e. riding a stationary bicycle), including: NYHA class III or IV congestive heart failure, uncontrolled angina, myocardial infarction in the prior 12 months, orthopedic surgery in the previous 6 months or plans for orthopedic surgery during the study period, chronic uncontrolled pulmonary conditions such as uncontrolled asthma (symptoms > 2 days/week) or dyspnea requiring oxygen, symptomatic peripheral vascular disease, or any other comorbidity that would interfere with the ability to complete and comply with the protocol in the opinion of the investigator Metastatic breast cancer a. History of prior treated malignancies, other than breast cancer, that are now stable, are in remission, and do not require active therapy, are acceptable. Patients requiring chronic anticoagulation are excluded from participation in the optional muscle biopsy collection.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jackson Richey
Phone
317-274-0922
Email
jaerich@iupui.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Tarah Ballinger, MD
Email
tarab@iu.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tarah Ballinger, MD
Organizational Affiliation
Indiana University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Indiana University Melvin & Bren Simon Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jackson Richey
Phone
317-274-0922
Email
jaerich@iupui.edu

12. IPD Sharing Statement

Learn more about this trial

Effect of Low Intensity Vibration (LIV) on Aromatase Inhibitor- Induced Musculoskeletal Dysfunction in Early Stage Breast Cancer Survivors

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