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Preoperative Exercise in Pancreatic Cancer


2016-05-10


2017-01-20


2021-01


3

Study Overview

Preoperative Exercise in Pancreatic Cancer

The purpose of this study is to investigate the effects of a preoperative exercise program in patients with pancreatic cancer preparing for surgery. Preoperative exercise programs have been shown to be effective in other cancer populations, but have not been investigated in patients with pancreatic cancer. The outcomes in this study will be changes in physical fitness, function, and postoperative outcomes. This investigation is a non-randomized control trial, with participants assigned to receive the preoperative exercise intervention in addition to standard care, or standard care alone if unable to commit to an exercise program for practical reasons. Possible mediators for the effects of exercise on postoperative outcomes will also be assessed, including psychological outcomes and markers of systemic inflammation. These measures will be assessed in all participants prior to program initiation, prior to surgery, and after surgery. Changes in these measures in response to exercise will be assessed, as well as the ability of the preoperative measures to predict postoperative outcomes.

This study focuses on patients prescribed neoadjuvant (preoperative chemotherapy and radiation) prior to surgery for borderline resectable pancreatic adenocarcinoma. This allows for a known, preoperative window long enough to provide an effective exercise intervention. The exercise program will be administered for at least eight weeks, but has no cap on length, as neoadjuvent treatment periods can vary between participants and a cessation of the exercise program before the end of this period could result in an undesirable loss in physical fitness and function. The study is a non-randomized, parallel group, intervention control trial, based on pilot studies in similar patient populations. All participants meeting the inclusion criteria and able to participate in the exercise program will be assigned to the exercise group. Participants meeting the inclusion criteria, but unable to commit to the exercise program for practical reasons (transportation, location, etc), will be assigned to the standard care group.

  • Pancreatic Cancer
  • BEHAVIORAL: Exercise program
  • OTHER: Standard Care
  • 15-2266.cc

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

2015-12-29  

2021-10-07  

2021-11-29  

2016-01-06  

2021-11-29  

2021-11-30  

2016-01-07  

2021-11-30  

2021-11  

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:
Non Randomized


Interventional Model:
Parallel


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
EXPERIMENTAL: Exercise Group

Participants will complete an exercise program in addition to standard care. Participants will start the exercise program within four weeks of their diagnosis and decision to undergo neoadjuvant treatment and continue until surgery. Participants will be e

BEHAVIORAL: Exercise program

  • Individual exercise sessions in this program implement a "whole body" approach and consist of a 10-min cardiovascular warm-up and 50 minutes of cardiovascular endurance, resistance, and flexibility exercises. Target intensity of exercise will be based on

OTHER: Standard Care

  • The services that participants receive as standard care include their medical care, symptom control, social worker support, and nutrition. These services are provided by their oncology team.
ACTIVE_COMPARATOR: Standard Care

Participants in the Standard Care group will receive no exercise intervention, but will continue to receive standard follow-ups, treatments and services from their oncology team.

OTHER: Standard Care

  • The services that participants receive as standard care include their medical care, symptom control, social worker support, and nutrition. These services are provided by their oncology team.
Primary Outcome MeasuresMeasure DescriptionTime Frame
Change in 400-meter Walk TimeAssessment of physical fitness and function. Participants are timed while walking 400 meters at a fast, but safe, pace.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Change in Body CompositionAssessment of physical fitness. Dual-energy x-ray absorptiometry (DXA) will assess lean muscle mass and body fat.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Gait SpeedParticipant gait speed will be determined on a 10 meter course for both fast and self-selected paces.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Timed Up and GoParticipants are timed as they rise from a chair, walk 3 meters, turn around, and return to the chair and sit.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Stair Climb TestParticipants are timed as they ascend and descend one flight of stairs.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Single Limb StanceParticipants are timed on how long they can balance on one leg.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in 30 Second Sit-to-StandThe number of times a participant can rise from a chair in 30 seconds is counted.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Grip StrengthThe maximum force the participant can produce separately with both hands, assessed by grip dynamometry, is measured.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Average Daily Step CountThe average step count for a minimum of 3 days over a 7 day period will be assessed with accelerometry.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in WellnessThe Colorado Comprehensive Wellness Assessment, a survey, will be administered to assess eight domains of wellness.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Health-related Quality of LifeThe Functional Assessment of Cancer Therapy - General Form (FACT-G), a survey, will be administered.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Perceived FatiguePerceived fatigue will be assessed by the Revised Piper Fatigue Scale, a survey.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in AnxietyChanges in state and trait anxiety will be assessed with the Spielberger State-Trait Anxiety Index.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Perceived StressChanges in perceived stress will be assessed with the Perceived Stress Scale.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Resting Heart Rate VariabilityHeart rate variability will be assessed from electrocardiography (ECG) obtained during a 5 min rest period.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Heart Rate Variability Response to Physiologic ChallengeHeart rate variability will be assessed from electrocardiography (ECG) obtained during a 5 min rest period, and changes in response to a physiologic challenge (orthostatic stress: chair rise).Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Heart Rate Variability Response to Mental StressorHeart rate variability will be assessed from electrocardiography (ECG) obtained during a 5 min rest period, and changes in response to a mental challenge (Stroop Task).Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Heart Rate Variability Response to a Cancer-specific Mental StressorHeart rate variability will be assessed from electrocardiography (ECG) obtained during a 5 min rest period, and changes in response to a cancer-specific mental challenge (Cancer-Specific Stroop Task).Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in C-reactive ProteinSerum C-reactive protein will be assessed from blood draws.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Interleukin-6Serum interleukin-6 will be assessed from blood draws.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Soluble Tumor-necrosis Factor Receptor 1Soluble tumor-necrosis factor receptor 1 will be assessed from blood draws.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Change in Interleukin-10Serum interleukin-10 will be assessed from blood draws.Baseline, Pre-operative (within the 2 weeks prior to surgery), 6 weeks postoperative
Determination of Hospital Length of StayAt 30 days after discharge from the hospital, a medical record review will be conducted to determine the number of days participants were in the hospital after surgery.30 days after hospital discharge
Determination of Hospital ReadmissionAt 30 days after discharge from the hospital, a medical record review will be conducted to determine whether participants were readmitted to the hospital for an unplanned surgical complication in the 30 days following hospital discharge.30 days after hospital discharge

Contacts and Locations

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

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:
21 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:

  • Recent (< 4 week) first diagnosis of a borderline resectable pancreatic adenocarcinoma
  • Prescription to receive neoadjuvant therapy and surgery,
  • Age 21 to 80 years old,
  • Physician clearance to participate in exercise program.

  • Exclusion Criteria:

  • Any significant comorbid conditions that would interfere with or preclude participation in an exercise intervention, including orthopedic conditions such as advanced osteoarthritis, mobility-limiting amputations or chronic injuries, or mobility-limiting acute orthopedic injuries
  • Advanced rheumatoid arthritis
  • Widespread chronic pain conditions such as fibromyalgia
  • Pulmonary conditions such as chronic obstructive pulmonary disease, emphysema, interstitial lung disease, use of supplementary oxygen
  • Known cardiovascular disease or new cardiac event in last 6 months
  • Diabetes
  • Pregnancy
  • Second cancer diagnosis at the time of enrollment

Collaborators and Investigators

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


    • PRINCIPAL_INVESTIGATOR: Catherine Jankowski, PhD, University of Colorado, Denver

    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