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Exercise in Older Women With Breast Cancer During Systemic Therapy

Not Applicable
Completed
Conditions
Breast Cancer
Interventions
Other: Breast cancer exercise intervention
Registration Number
NCT03656731
Lead Sponsor
Herlev and Gentofte Hospital
Brief Summary

BREACE is a prospective randomized controlled trial. The aim is to investigate the effect of an exercise-based intervention among older participants with breast cancer treated with adjuvant or first-line systemic therapy.

The hypotheses: That the intervention will maintain or increase physical function levels, reduce symptoms and side effects, improve quality of life and psychological wellbeing, and prevent weight loss and muscle wasting

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
68
Inclusion Criteria

Participants must:

  • Be operated for primary breast cancer within 12 weeks or
  • Be diagnosed with locally advanced or metastatic breast cancer. Be treated with (neo)adjuvant or first or second-line palliative therapy defined as chemotherapy ± HER2 directed treatment, ± antihormonal treatment, antihormonal treatment ± HER 2, directed treatment ± CDK 4/6 inhibitor.
  • Be ≥ 65 years of age at the time of signing the informed consent form
  • Have an Eastern Cooperative Oncology Group (ECOG) performance status score ≤ 2
  • Be able to speak and read Danish, and to provide a signed informed consent form.
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Exclusion Criteria

Participants with:

  • Any physical condition that hinder the execution of physical exercise training
  • Other types of cancer
  • Documented and uncontrolled brain metastases that hinder participation in an exercise-based trial, based on the referring oncologist's assessment
  • Dementia, psychotic disorders, or other cognitive diseases or conditions that hinder written consent
  • Unstable medical disease or history of serious or concurrent illness; any medical condition that might be aggravated by exercise training or that cannot be controlled, including, but not restricted congestive heart failure (NYHA class III-IV), unstable angina pectoris, implantable cardioverter defibrillator (ICD), or myocardial infarction within 6 months, based on the referring oncologist's assessment.

In patients with documented bone metastases:

  • A bone metastatic burden or location that poses a risk of injury in the performance of exercise training, as assessed by the referring oncologist.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention group (n=50)Breast cancer exercise interventionPatients in the intervention group will receive standard care and a 12-week exercise-based intervention.
Primary Outcome Measures
NameTimeMethod
Change in the 30-second chair stand testbaseline, 6 weeks, 12 weeks and 24 weeks

To measure change over time in the lower extremity strength, the number of stands a participant can complete in 30-seconds from a seated position with their arms crossed over the chest, is registered.

Secondary Outcome Measures
NameTimeMethod
whole-body mineral densitybaseline and 12 weeks

Measured with bioimpedance and DXA scans

whole-body fat massbaseline and 12 weeks

Measured with bioimpedance and DXA scans

The 6-meter Gait Speed Testbaseline, 6 weeks, 12 weeks and 24 weeks

To asses physical performance at normal and maximal gait speed. The assessment will be conducted by blinded physiotherapist.

Adherence to exercise sessionsUp to 12 weeks

Number of exercise sessions attended out of planned sessions

Common Toxicity Criteria for Adverse Events version 4up to 6 months

Number of participants with side-effects to oncological treatment assessed with the Common Toxicity Criteria for Adverse Events version 4. Data will be collected from medical records.

Body weightbaseline, 6 weeks, 12 weeks and 24 weeks

Weight will be assessed using standard procedures (no shoes, light clothing) and will be reported in kilograms

The 6-minute-walk-testbaseline, 6 weeks, 12 weeks and 24 weeks

To measure physical capacity and endurance. The distance (measured in meters) a participant is able to walk over a total of six minutes on a hard flat surface. The assessments will be conducted by a blinded physiotherapist

Physical activity levelbaseline and 12 weeks

Data of step counts will be assessed daily for participants in the intervention group and will be measured with an activity tracker.

European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30baseline, 6 weeks, 12 weeks and 24 weeks

Measure quality of life with the EORTC QLQ-C30 patient questionnaire. The questionnaire comprises 30 items, is designed to be cancer specific, and consists of six functional scales (physical, role, cognitive, emotional, social functioning, and global QOL) and symptom scales (fatigue, nausea/vomiting, sleep disturbance, constipation, diarrhea, appetite loss, dyspnea).

The 10-meter Gait Speed Testbaseline, 6 weeks, 12 weeks and 24 weeks

To asses physical performance at normal and maximal gait speed. The assessment will be conducted by blinded physiotherapist

Stair climb testbaseline, 6 weeks, 12 weeks and 24 weeks

To measure lower extremity muscle power. The patient will climb a flight of stairs (20 steps) as fast as possible. The assessment will be conducted by blinded physiotherapist.

InflammationData will be recorded from the medical records

Inflammatory biomarkers: c-reactive protein, interleukin 6, YKL-40, GDF11 and GDF15.

Lengths of hospitalizationsup to 6 months

Data will be collected from medical records

whole-body lean body mass (LBM)baseline and 12 weeks

Measured with bioimpedance and DXA scans

The Handgrip Strength Testbaseline, 6 weeks, 12 weeks and 24 weeks

Physical function of the upper body will be measured using hand-held dynamometer. The assessment will be conducted by blinded physiotherapist

Survivalup to 6 months

Incidences of deaths (cancer-related and other cause) will be registered. The purpose is to investigate whether the intervention may affect survival time/mortality. Data will be collected from medical records.

European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire BR23baseline, 6 weeks, 12 weeks and 24 weeks

Measure quality of life with the EORTC QLQ-BR23 patient questionnaire. The questionnaire is a breast cancer specific module to EORTC-QLQ-C30, comprises 23 items and consist of functional scales and symptom scales. Each item is scored on a scale from 1 to 4. 1 being "not at all" and 4 being "very much".

M.D. Anderson Symptom Inventory (MDASI)baseline, 6 weeks, 12 weeks and 24 weeks

The MDASI patient questionnaire measures the severity of symptoms and the interference with daily living asses by the participant based on the last 24 hours. The questionnaire consist of 13 core symptom items representing symptoms that have been found to have the highest frequency and/or severity among cancer patients with various cancers and treatment types, and 6 interference items representing commonly experienced symptom interference with daily activities.

Hospital Anxiety and Depression Scale (HADS)baseline, 6 weeks, 12 weeks and 16 weeks

Measure symptoms of depression and anxiety with the HADS patient questionnaire. The questionnaire comprises a total of 14 items, generates ordinal data, and is designed to measure general anxiety and depression by self-administration. Seven of the items relate to anxiety and seven relate to depression. Each item is scored on a scale from 0 to 3 and this mean a participant can score between 0 and 21 for either anxiety and depression. Scores categorized as follows: normal 0-7, mild 8-10, moderate 11-14, and severe 15-21.

Body mass indexbaseline, 6 weeks, 12 weeks and 24 weeks

Reported in kg/m\^2

Adverse eventsup to 12 weeks

Cases of exercise-related injuries or events, including, but not restricted to musculoskeletal-related events, falls, fall-related injuries, bleedings, or cardiovascular events.

Number of hospitals admissionsup to 6 months

Data will be collected from medical records

Causes of hospitalizationsup to 6 months

Data will be collected from medical records

Trial Locations

Locations (1)

Herlev and Gentofte Hospital

🇩🇰

Herlev, Copenhagen, Denmark

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