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Evaluation of an Adapted Physical Activity Program in Patients With Unresectable Pancreatic Cancer

Not Applicable
Active, not recruiting
Conditions
Metastatic Pancreatic Cancer
Unresectable Locally Advanced Cancer
Interventions
Other: without APA program
Other: APA program
Registration Number
NCT02184663
Lead Sponsor
GERCOR - Multidisciplinary Oncology Cooperative Group
Brief Summary

Adapted Physical Activity (APA) program may provide an opportunity to improve symptoms for patients with unresectable pancreatic cancer.

Thereby, it is proposed to conduct an open trial to assess effects of the APA program in such population

Detailed Description

The benefit of Adapted Physical Activity (APA) has been demonstrated after cancer diagnosis in term of symptomatic improvement: reducing fatigue, pain and improving the quality of life, psychological and emotional state, and adherence to treatment.

The aim of the study is to assess the effects of an APA program in pancreatic cancer population treated by usual chemotherapy.

200 randomized patients are required.

The program is organized in 16 weeks. During the trial, assessments include: aerobic exercises, muscular strength, six-minute walk test, body composition (bioimpedance, L3 CT-scan), level of physical activity - International Physical Activity Questionnaire - (IPAQ questionnaire), fatigue - Multidimensional Fatigue Inventory - (MFI-20 questionnaire), quality of life - EORTC Quality of Life questionnaire C-30 - (EORTC QLQ-30 questionnaire), depression symptom - Hospital Anxiety and depression scale - (HADS questionnaire), pain (Brief Pain Inventory Short form), and nutritional evaluation (BMI, ingests EVA).

Furthermore, relationships between insulin resistance, insulin secretion, Insulin like Growth Factor 1 (IGF-1) and pancreatic carcinogenesis exist. APA may improve the quality of life in decreasing insulin-resistance, insulin secretion and IGF-1.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
313
Inclusion Criteria
  • Histologically proven non resectable pancreatic adenocarcinoma
  • Indication of palliative chemotherapy
  • Life expectancy ≥ 3 months
  • Eastern Cooperative oncology group (ECOG) - Performance status ≤2
  • Age ≥18 years old
  • At least one measurable lesion as assessed by CT-scan or MRI (Magnetic resonance Imaging)
  • Identified Accompanying partner Adapted Physical Activity (AAPA)
  • Signed and dated informed consent
  • Registration in a National Health Care System (CMU included for France)
Exclusion Criteria
  • Previous Cerebrovascular accident or myocardial infarction <6months
  • Uncontrolled hypertension.
  • Severe cardiovascular or respiratory disease
  • Severe cognitive or psychiatric disorder
  • Severe motor and/or sensory neuropathy
  • Rheumatologic or orthopedic problem or bone lesions with a fracture risk
  • Others comorbidities contra-indicated physical exercises
  • Patient protected by the law - Guardianship and trusteeship

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard care without APA programwithout APA programThe control arm corresponds to usual care (without APA), including : * Weekday hospital chemotherapy (every 7 or 14 days, depending on chemotherapy protocol) * Evaluation by the oncologist at the usual rate * Assessment every 8 weeks (TAP scan + CA-19.9) * Nutritional, psychological and pain management as recommended, according to the usual schedule.
Standard care with APA programAPA programThe experimental arm corresponds to usual care, combined with a 16-week APA program. The APA program consisted of personalized aerobic and resistance exercises, with a weekly remote supervision by an APA professional trainer, and unsupervised sessions with a family member or friend (APA partner).
Primary Outcome Measures
NameTimeMethod
Health-related quality of life (HRQoL) at 16 weeksAt 16 weeks

HRQoL at week 16 according to the EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) with three targeted dimensions: global health status, physical function and fatigue.

Secondary Outcome Measures
NameTimeMethod
MFI-20 and EORTC QLQ C-30 evaluationat 6, 12 et 24 months
General state - Performance status OMSup to 24 months
medico-economic evaluationup to 24 months
Brief Pain Inventory Short form questionnaireUp to 24 months
Time To deterioration (TTD)Up to 24 months
Nutritional status evaluationup to 24 months

Nutritional Status will be measured by weigth, Body Mass Index, body composition, EVA ingests, caloric intake and protidic, albumin/prealbumin, inflammation markers (PNN and CRP)

Physical Activity evaluation - IPAQ questionnaireup to 24 months

Six minutes walk test, dyspnea scale, Borg scale, muscular pain, strength test with bands and compliance program

Progression free survival (PFS)2 years
Patient depression scale - HADS questionnaireUp to 24 months
Accompanying partner depression scale (HADS questionnaire)up to 24 months
Number of Adverse events (AE) grade 3 -4up to 24 months
analgesic consumptionup to 24 months
Overall Survival (OS)2 years
Fatigue scale (EVA fatigue)up to 24 months
visual analog scale for painup to 24 months
anxiolytic / antidepressant consumptionup to 24 months

Trial Locations

Locations (17)

Centre Hospitalier de Belfort

🇫🇷

Montbéliard, France

CHU Robert Debré

🇫🇷

Reims, France

Hôpital Beaujon

🇫🇷

Clichy, France

Polyclinique Bordeaux Nord Aquitaine

🇫🇷

Bordeaux, France

CHD Vendée

🇫🇷

La Roche Sur Yon, France

CHU Morvan

🇫🇷

Brest, France

Hôpital Henri Mondor

🇫🇷

Creteil, France

Centre Georges François Leclerc

🇫🇷

Dijon, France

Institut Hospitalier Franco-Britannique

🇫🇷

Levallois Perret, France

Centre Léon Bérard

🇫🇷

Lyon, France

CH Saint Joseph Saint Luc

🇫🇷

Lyon, France

Hôpital Européen

🇫🇷

Marseille, France

CH Mont de Marsan

🇫🇷

Mont de Marsan, France

Hôpital Cochin

🇫🇷

Paris, France

Hôpital Saint Antoine

🇫🇷

Paris, France

Institut de cancérologie de Lorraine

🇫🇷

Vandoeuvre Les Nancy, France

Hôpital FOCH

🇫🇷

Suresnes, France

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