Breast Neoplasms Clinical Trial
Official title:
EXercise Influence on Taxane Side Effects (EXIT) Study
This study is a randomized control cross over trial of exercise training during or after taxane-containing chemotherapy treatment for breast cancer. Forty-three women with stage I-III breast cancer will be randomized to immediate or delayed thrice weekly exercise training for 8-12 weeks. The immediate exercise group will exercise during taxane chemotherapy and the delayed group will start exercise 2 weeks after completion of treatment. This design will allow for an assessment of the effects of exercise vs usual care during treatment, plus a comparison of the training response during vs. after chemotherapy.
Purpose The purpose of this study is to evaluate the effects of aerobic and resistance
exercise training relative to usual care during taxane-containing chemotherapy treatment for
breast cancer.
Hypotheses
Relative to usual care, aerobic and resistance exercise training during taxane-containing
chemotherapy treatment for breast cancer will:
1. mitigate the experience of patient reported outcomes
2. reduce medical management of taxane side effects and adverse events
3. attenuate autonomic dysfunction and maintain resting cardiovascular function and
cardiovascular response to exercise
4) Objectives The primary aim of this study is to determine whether aerobic and resistance
exercise training during taxane-containing chemotherapy treatment reduces patient-reported
side effects, medical management and clinical adverse events reported relative to usual care.
The secondary aim is to determine the whether aerobic and resistance exercise training during
taxane-containing chemotherapy attenuates the occurrence of indices of autonomic dysfunction
relative to usual care.
5) Research methods This study is a randomized control trial with crossover. The intervention
consists of aerobic, resistance and balance training three times a week. Forty-three women
with a stage I-III breast cancer diagnosis who are scheduled to receive taxane-containing
chemotherapy will be randomized to immediate or delayed exercise (stratified by treatment
protocol). Potential participants will be referred by oncologist referral, or will be
self-referred by recruitment posters, social media or word of mouth.
6) Statistical analysis The primary outcome measure is the EORTC CIPN subscale of
patient-reported symptoms related to neurotoxic chemotherapy. Secondary outcome measures
include measures of autonomic dysfunction including heart rate and blood pressure
variability, and medical management of taxane-related side effects, and clinical adverse
events related to treatment.
The chemotherapy-induced peripheral neuropathy (CIPN) sub-scale of the EORTC Quality of life
Questionnaire is used as the primary outcome measure to determine sample size. G*Power 3.0.10
was used to estimate sample size for independent t-tests between the two groups (at the
2-week post chemotherapy time point). At thirty-six participants, we will have 80% power to
detect a medium (d=0.6) effect size in the EORTC CIPN-20 subscale at an alpha of 0.05
(one-tailed) . An additional 20% will be recruited to allow for dropout or non-adherence,
making the final total sample size goal 43 participants.
Baseline characteristics and outcome measures of the two groups will be compared with
independent t-tests. To assess the effect of the exercise intervention during treatment,
independent t-tests will be used to compare the outcome measures at two weeks post completion
of taxane chemotherapy if no difference exists between groups baseline measures. For the
exercise group, all outcome measures at time point 2 will be compared to time point 3 using
paired t-tests to assess maintenance over time. Independent t-tests will first be used to
determine whether significant differences exists between groups for the three exploratory
measure time points. If no differences exist, all data will be combined, and analyzed with a
repeated measures analysis of variance to determine whether differences exist.
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