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Feasibility of a Health Care Provider Guided Exercise Intervention Prior to Surgical Resection of Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
HCP-Guided Exercise Training Program
Sponsored by
NYU Langone Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Pancreatic Cancer focused on measuring HCP-Guided Exercise

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Willingness and ability to participate in the study procedures
  2. Pathologically confirmed pancreatic cancer
  3. Candidate for neoadjuvant therapy followed by surgical resection with potentially curative intent. Note: There is no limitation on duration of neoadjuvant therapy.
  4. Planned to have at least 2 weeks after completing the last neoadjuvant therapy and surgery
  5. Over the age of 18
  6. Ability to engage in physical activity as determined by physiatrist review after completion of the Physical Activity Readiness questionnaire (PAR-Q) exercise survey and chart review
  7. Agree to study blood draws and tissue collection

Exclusion Criteria:

  1. Evidence of metastatic disease
  2. Inability to complete physical activity due to recent injury or surgery
  3. Uncontrolled heart disease limiting physical activity
  4. Participation in another interventional trial that excludes participation in this protocol
  5. Subjects who anticipate undergoing a procedure during the course of the trial that will render them unable to engage in physical activity for more than 48 hours
  6. Pregnant subjects
  7. Individuals who lack the capacity to consent

Sites / Locations

  • NYU Langone Health Ambulatory Care CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

HCP-Guided Exercise

Control

Arm Description

Participants will schedule twice-weekly in-person visits to conduct health care provider (HCP)-supervised exercise activity for a minimum of 30 minutes. At least 3 additional times per week, participants will conduct self-directed exercise at home. Activity and other outcomes will be monitored with an Actigraph Centrepoint Insight Watch. The HCP guided therapy will continue on a weekly basis for at least 2 weeks and up to a maximum of 4 weeks.

Participants will not participate in the HCP-guided exercise intervention but will wear the Actigraph Centrepoint Insight Watch.

Outcomes

Primary Outcome Measures

Number of Intervention Arm Participants in Compliance with HCP Exercise Intervention
Compliance with HCP exercise intervention is defined as successful completion of at least 150 minutes of weekly moderate-to-intense physical activity over a minimum of 2 weeks for every week of the prescribed intervention (2, 3 or 4 weeks).

Secondary Outcome Measures

Number of Participants who Experience Adverse Events (AEs)
AEs defined as any symptom, sign, illness or experience that develops or worsens in severity during the course of the study.
Number of Participants who Experience an Event that Leads to Delay in Surgical Resection
Change in Number of Tumor-Infiltrating CD8-Positive T Cells
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of cluster designation 8 (CD8)-positive T cells.
Change in Number of Tumor-Infiltrating CD8-Positive T Cells Expressing IL-15Ra
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of CD8-positive T cells expressing Interleukin 15 Receptor Alpha Subunit (IL-15Ra).
Change in Number of Tumor-Infiltrating CD8-Positive T Cells Expressing GZMB
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of CD8-positive T cells expressing Granzyme B (GZMB).
Change in Number of Tumor-Infiltrating CD8-Positive T Cells Expressing CD3
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of CD8-positive T cells expressing cluster designation 3 (CD3).
Change in Number of Circulating CD8-Positive T Cells Expressing IL-15Ra as Assessed by Flow Cytometry
Flow cytometry conducted on patient blood samples to assess number of circulating CD8-positive T cells expressing Interleukin 15 Receptor Alpha Subunit (IL-15Ra).
Time Spent in Moderate-to-Vigorous Physical Activity (MVPA)
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. Moderate Activity is defined as between 3.00 and 5.99 metabolic equivalents (METs). Vigorous Activity is defined as at least 6.00 METs. MET is defined as the ratio of the work metabolic rate to the resting metabolic rate.
Time Spent in Sedentary Behavior
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. Sedentary Behavior is defined as less than 0.11 metabolic equivalents (METs). MET is defined as the ratio of the work metabolic rate to the resting metabolic rate.
Average Daily MET Rates
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. MET is defined as the ratio of the work metabolic rate to the resting metabolic rate. Light intensity activities are defined as less than 3 METs, moderate intensity activities are defined as between 3 and 5.99 METs, and vigorous intensity activities are defined as 6 METs or greater.
Total Physical Activity Energy Expenditure
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. Expressed in kcal/day.
Minutes Spent in Rapid Eye Movement (REM) Sleep
Monitored using ActiGraph Centrepoint Insight Watch.

Full Information

First Posted
July 29, 2022
Last Updated
November 23, 2022
Sponsor
NYU Langone Health
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1. Study Identification

Unique Protocol Identification Number
NCT05483075
Brief Title
Feasibility of a Health Care Provider Guided Exercise Intervention Prior to Surgical Resection of Pancreatic Cancer
Official Title
An Exploratory Study Evaluating the Feasibility of a Health Care Provider Guided Exercise Intervention Prior to Surgical Resection of Pancreatic Cancer With Biological Correlative Studies
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 15, 2022 (Actual)
Primary Completion Date
September 1, 2023 (Anticipated)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NYU Langone Health

4. Oversight

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

5. Study Description

Brief Summary
Pilot study evaluating the feasibility of a 2-4 week health care provider guided exercise intervention prior to surgery for pancreatic cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
HCP-Guided Exercise

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
HCP-Guided Exercise
Arm Type
Experimental
Arm Description
Participants will schedule twice-weekly in-person visits to conduct health care provider (HCP)-supervised exercise activity for a minimum of 30 minutes. At least 3 additional times per week, participants will conduct self-directed exercise at home. Activity and other outcomes will be monitored with an Actigraph Centrepoint Insight Watch. The HCP guided therapy will continue on a weekly basis for at least 2 weeks and up to a maximum of 4 weeks.
Arm Title
Control
Arm Type
No Intervention
Arm Description
Participants will not participate in the HCP-guided exercise intervention but will wear the Actigraph Centrepoint Insight Watch.
Intervention Type
Behavioral
Intervention Name(s)
HCP-Guided Exercise Training Program
Intervention Description
Individually tailored exercise program consisting of aerobic training (5 days per week for a minimum of 30 minutes at moderate intensity) and strength training (2 days per week at moderate intensity). Two days per week the participant will receive their exercise program at NYU Langone Health. When at NYU, the training will be supervised by a physical therapist and will consist of the following: warm-up of 5 minutes, 30 minutes of aerobic exercise on either a stationary bike or treadmill at 60-70% of maximum heart rate. Following aerobic training, strength training will be carried out. Strength training will consist of 1 exercise per major muscle group, 8-12 reps, 1-3 sets at moderate intensity. The remaining three days a week the participant will perform aerobic training at home by exercising on a bicycle or by walking fast for a minimum of 30 mins at moderate intensity (60-70% of max HR).
Primary Outcome Measure Information:
Title
Number of Intervention Arm Participants in Compliance with HCP Exercise Intervention
Description
Compliance with HCP exercise intervention is defined as successful completion of at least 150 minutes of weekly moderate-to-intense physical activity over a minimum of 2 weeks for every week of the prescribed intervention (2, 3 or 4 weeks).
Time Frame
Up to Week 4
Secondary Outcome Measure Information:
Title
Number of Participants who Experience Adverse Events (AEs)
Description
AEs defined as any symptom, sign, illness or experience that develops or worsens in severity during the course of the study.
Time Frame
Up to Week 4
Title
Number of Participants who Experience an Event that Leads to Delay in Surgical Resection
Time Frame
Up to Week 4
Title
Change in Number of Tumor-Infiltrating CD8-Positive T Cells
Description
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of cluster designation 8 (CD8)-positive T cells.
Time Frame
Baseline, Final Study Visit (Between Weeks 2-4)
Title
Change in Number of Tumor-Infiltrating CD8-Positive T Cells Expressing IL-15Ra
Description
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of CD8-positive T cells expressing Interleukin 15 Receptor Alpha Subunit (IL-15Ra).
Time Frame
Baseline, Final Study Visit (Between Weeks 2-4)
Title
Change in Number of Tumor-Infiltrating CD8-Positive T Cells Expressing GZMB
Description
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of CD8-positive T cells expressing Granzyme B (GZMB).
Time Frame
Baseline, Final Study Visit (Between Weeks 2-4)
Title
Change in Number of Tumor-Infiltrating CD8-Positive T Cells Expressing CD3
Description
Multiplex immune-fluorescence staining conducted on tumor tissue samples to assess number of CD8-positive T cells expressing cluster designation 3 (CD3).
Time Frame
Baseline, Final Study Visit (Between Weeks 2-4)
Title
Change in Number of Circulating CD8-Positive T Cells Expressing IL-15Ra as Assessed by Flow Cytometry
Description
Flow cytometry conducted on patient blood samples to assess number of circulating CD8-positive T cells expressing Interleukin 15 Receptor Alpha Subunit (IL-15Ra).
Time Frame
Baseline, Final Study Visit (Between Weeks 2-4)
Title
Time Spent in Moderate-to-Vigorous Physical Activity (MVPA)
Description
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. Moderate Activity is defined as between 3.00 and 5.99 metabolic equivalents (METs). Vigorous Activity is defined as at least 6.00 METs. MET is defined as the ratio of the work metabolic rate to the resting metabolic rate.
Time Frame
Up to Week 4
Title
Time Spent in Sedentary Behavior
Description
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. Sedentary Behavior is defined as less than 0.11 metabolic equivalents (METs). MET is defined as the ratio of the work metabolic rate to the resting metabolic rate.
Time Frame
Up to Week 4
Title
Average Daily MET Rates
Description
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. MET is defined as the ratio of the work metabolic rate to the resting metabolic rate. Light intensity activities are defined as less than 3 METs, moderate intensity activities are defined as between 3 and 5.99 METs, and vigorous intensity activities are defined as 6 METs or greater.
Time Frame
Up to Week 4
Title
Total Physical Activity Energy Expenditure
Description
Monitored using the ActiGraph Centrepoint Insight Watch in conjunction with ActiLife software and validated algorithms. Expressed in kcal/day.
Time Frame
Up to Week 4
Title
Minutes Spent in Rapid Eye Movement (REM) Sleep
Description
Monitored using ActiGraph Centrepoint Insight Watch.
Time Frame
Up to Week 4

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willingness and ability to participate in the study procedures Pathologically confirmed pancreatic cancer Candidate for neoadjuvant therapy followed by surgical resection with potentially curative intent. Note: There is no limitation on duration of neoadjuvant therapy. Planned to have at least 2 weeks after completing the last neoadjuvant therapy and surgery Over the age of 18 Ability to engage in physical activity as determined by physiatrist review after completion of the Physical Activity Readiness questionnaire (PAR-Q) exercise survey and chart review Agree to study blood draws and tissue collection Exclusion Criteria: Evidence of metastatic disease Inability to complete physical activity due to recent injury or surgery Uncontrolled heart disease limiting physical activity Participation in another interventional trial that excludes participation in this protocol Subjects who anticipate undergoing a procedure during the course of the trial that will render them unable to engage in physical activity for more than 48 hours Pregnant subjects Individuals who lack the capacity to consent
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Paul Oberstein, MD
Phone
212-731-6120
Email
paul.oberstein@nyulangone.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Oberstein, MD
Organizational Affiliation
NYU Langone Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
NYU Langone Health Ambulatory Care Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Oberstein, MD
Phone
212-731-6120
Email
paul.oberstein@nyulangone.org

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The de-identified participant data from the final research dataset used in the published manuscript will be shared upon reasonable request beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research provided the investigator who proposes to use the data executes a data use agreement with NYU Langone Health. Requests may be directed to: Paul Oberstein 212-731-6120 paul.oberstein@nyulangone.org The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.
IPD Sharing Time Frame
Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.
IPD Sharing Access Criteria
The investigator who proposed to use the data will have access to the data upon reasonable request. Requests should be directed to paul.oberstein@nyulangone.org. To gain access, data requestors will need to sign a data access agreement.

Learn more about this trial

Feasibility of a Health Care Provider Guided Exercise Intervention Prior to Surgical Resection of Pancreatic Cancer

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