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Exploring the Impact of a Multi-modal Nutritional Intervention in Patients Undergoing Chemotherapy for Pancreatic Cancer (FEED Trial)


2024-05-01


2027-11


2028-11


70

Study Overview

Exploring the Impact of a Multi-modal Nutritional Intervention in Patients Undergoing Chemotherapy for Pancreatic Cancer (FEED Trial)

The study will examine if a multi-modal nutritional care package, with or without resistance training delivered with neoadjuvant chemotherapy, is effective at preventing loss of muscle strength during neoadjuvant chemotherapy for pancreatic cancer. There are two arms in this study: Control Arm will receive standard dietetic care and be prescribed standard pancreatic enzyme replacement therapy and oral nutritional supplement drinks with their neoadjuvant chemotherapy. The intervention Arm will have 3 additional dietitian visits and 6 physiotherapist visits that the control group will not.

This is a translational, single-site, open-label, randomised, prospective 12-week study. 70 (35 in each arm) patients will be enrolled in the study; The study will examine if a multi-modal nutritional care package, with or without resistance training delivered concurrently to neoadjuvant chemotherapy, is effective at preventing loss of muscle strength during neoadjuvant chemotherapy for pancreatic cancer. There are two arms in this study: The control group will receive standard dietetic care and be prescribed standard pancreatic enzyme replacement therapy and oral nutritional supplement drinks concurrently with their neoadjuvant chemotherapy. The intervention group in comparison to the control group will have 3 additional dietitian visits and 6 physiotherapist visits that the control group will not.

  • Pancreatic Cancer
  • DIETARY_SUPPLEMENT: Control
  • DIETARY_SUPPLEMENT: Intervention
  • CTRIAL-IE 20-26

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2023-10-11  

N/A  

2025-07-04  

2023-11-20  

N/A  

2025-07-08  

2023-11-29  

N/A  

2025-07  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Supportive Care


Allocation:
Randomized


Interventional Model:
Parallel


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
EXPERIMENTAL: Control

* High protein, high energy diet * Fish oil supplement (ProSure®) * Pancreatic Enzymes (Creon®) * A daily individualised step target (10% above your own baseline) * Four scheduled appointments with a dietitian

DIETARY_SUPPLEMENT: Control

  • * High protein, high energy diet * Fish oil supplement (ProSure®) * Pancreatic Enzymes (Creon®) * A daily individualised step target (10% above your own baseline) * Four scheduled appointments with a dietitian
EXPERIMENTAL: Intervention

* High protein, high energy diet * Fish oil supplement (ProSure®) * Pancreatic Enzymes (Creon®) * A daily individualised step target (10% above your own baseline) * Seven scheduled appointments with a dietitian * Six scheduled appointments with a physioth

DIETARY_SUPPLEMENT: Intervention

  • * High protein, high energy diet * Fish oil supplement (ProSure®) * Pancreatic Enzymes (Creon®) * A daily individualised step target (10% above your own baseline) * Seven scheduled appointments with a dietitian * Six scheduled appointments with a physioth
Primary Outcome MeasuresMeasure DescriptionTime Frame
Effectiveness of a multi-modal nutrition-led intervention in preventing loss of muscle strength (hand-grip strength) during chemotherapyTo compare the effectiveness of a multi-modal nutrition-led intervention in preventing loss of muscle strength (Percentage change in handgrip strength as determined by handgrip dynamometry) during chemotherapy with an intensive multi-modal nutrition and physiotherapist delivered intervention (1:1 randomisation).12 weeks
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Effectiveness of the intervention compared to the control on weight changesTo compare the effectiveness of a multi-modal nutrition-led intervention on weight changes (kg and %) versus the control.12 weeks
To compare the effectiveness of the intervention compared to the control on treatment deliveryTreatment delivery will be defined based on the occurrence of dose limiting toxicity (NCI CTCAE grading V5).6 months
To compare the effectiveness of the intervention compared to the control on treatment deliveryTreatment delivery will be defined based on the need for dose reduction due to weight loss.6 months
To compare the effectiveness of the intervention compared to the control on treatment deliveryTreatment delivery will be defined based on unplanned hospital admissions (frequency, duration (days), reason).6 months
To compare the effectiveness of the intervention compared to the control on treatment responseTreatment response will be assessed by Resectability Status per National Cancer Control Network (NCCN)6 months
To compare the effectiveness of the intervention compared to the control on treatment responseTreatment response will be assessed by Radiographic Classification of Borderline Resectable Pancreatic Cancer6 months
To compare the effectiveness of the intervention compared to the control on patient acceptance/adherence.Patient acceptance/adherence is defined as attendance at dietetic and physiotherapy appointments, dose of ONS and PERT delivered vs prescribed, step target achievement, exercise program adherence and progress.12 weeks
Patient health-related quality of life (change in EORTC QLQ-C30 function or symptom score)To compare the effectiveness of a multi-modal nutrition-led intervention on patient health-related quality of life (change in European Organisation for Research and Treatment of Cancer - Core Quality of Life questionnaire (EORTC QLQ-C30) function or symptom score) versus the control. The core EORTC QLQ C30 questionnaire has five functioning subscale scores and nine symptoms subscale scores. Minimum value = 0; Max value = 100 Function Scales: Higher numbers mean better function Symptom Scale: Higher numbers mean more symptoms12 weeks
Change in Timed-up and Go (seconds) between control and intervention cohorts.To compare the effectiveness of a multi-modal nutrition-led intervention on function (change in Timed-up and Go (seconds)) versus the control.12 weeks
Changes in inflammatory markers and cytokine levels between control and intervention cohorts.Changes in C-reactive Protein (CRP) will be measured between control and intervention cohorts.12 weeks
Changes in inflammatory markers and cytokine levels between control and intervention cohorts.Changes in Tumour Necrosis Factor-alpha (TNF-α) will be measured between control and intervention cohorts.12 weeks
Changes in inflammatory markers and cytokine levels between control and intervention cohorts.Changes in Interleukin-6 (IL-6) will be measured between control and intervention cohorts.12 weeks
Changes in lumbar skeletal muscle index between control and intervention cohorts.To compare the effectiveness of a multi-modal nutrition-led intervention on lumbar skeletal muscle index (cm²/m²) via diagnostic and restaging CT scans.6 months
Changes in skeletal muscle between control and intervention cohorts.To compare the effectiveness of a multi-modal nutrition-led intervention on skeletal muscle (area in cm²) via diagnostic and restaging CT scans6 months
Changes in skeletal muscle between control and intervention cohorts.To compare the effectiveness of a multi-modal nutrition-led intervention on skeletal muscle (mass in kg) via diagnostic and restaging CT scans6 months
Effectiveness of the intervention compared to the control on body composition indicesTo compare the effectiveness of a multi-modal nutrition-led intervention on lumbar adipose tissue (area in cm²) via diagnostic and restaging CT scans.6 months
Effectiveness of the intervention compared to the control on body composition indicesTo compare the effectiveness of a multi-modal nutrition-led intervention on lumbar adipose tissue (mass in kg) via diagnostic and restaging CT scans.6 months
Effectiveness of the intervention compared to the control on body composition indicesTo compare the effectiveness of a multi-modal nutrition-led intervention on body composition indices: assessment of muscle attenuation (Hounsfield Units (HU)) via diagnostic and restaging CT scans.6 months
Effectiveness of the intervention compared to the control on Overall SurvivalOverall survival rate at 6 months following the first day of chemotherapy and median overall survival time.6 months

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Name: Cancer Trials Ireland

Phone Number: +35316677211

Email: info@cancertrials.ie

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:
    1. Ability to give signed informed consent and willing and able to comply with the protocol. 2. Patients aged 18 years and above. 3. Patients with newly diagnosed, pathologically confirmed pancreatic ductal adenocarcinoma who will undergo neoadjuvant chemotherapy following formal MDT assessment at St Vincent's University Hospital, specifically FOLFIRINOX or Gemcitabine with Nab-Paclitaxel (and/or any additional therapy regimen approved by NCCP). 4. Patients have CT scan available and suitable for body composition analysis within 8 weeks prior to randomisation. 5. Patients have adequate upper limb dexterity to allow assessment of hand grip strength.
    Exclusion Criteria:
    1. Patients who are unable to consume oral diet and require prolonged enteral and/or parenteral nutritional support. 2. Patient with any significant history of non-compliance to medical treatments or with inability to grant reliable informed consent. 3. Patients who can/will not consume fish and pork products due to allergy, intolerance, religious beliefs, or dietary preferences. 4. Patients with known blood clotting disorders, e.g antiphospholipid syndrome, factor V Leiden syndrome, haemophilia /any liver disease which has progressed to liver cirrhosis where prolonged fish oil supplementation is unsafe. 5. Patients with uncontrolled hypertension (BP >180/110 mm Hg) which prohibits exercise. 6. Patients with muscle wasting disorders, e.g. paraplegia, motor neuron disease, Duchenne muscular dystrophy, multiple sclerosis. 7. Women who are pregnant or breastfeeding due to differing nutritional needs and macronutrient metabolism.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.


    • PRINCIPAL_INVESTIGATOR: Oonagh Griffin, Dr, SVUH/University College Dublin

    Publications

    The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

    General Publications

    No publications available