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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04478175
Other study ID # IC 2020-01
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date April 29, 2021
Est. completion date October 5, 2022

Study information

Verified date November 2022
Source Institut Curie
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Patients with advanced gastrointestinal (GI) cancers are very often sarcopenic/malnourished at diagnosis (> 60% of cases) and at high risk of rapid clinical deterioration. These patients have important supportive care needs that represent a major challenge for improving treatment tolerance and patient survival and health-related quality of life (HRQoL). Malnutrition and sarcopenia (muscle wasting and dysfunction) are associated with an increased risk of death, complications from chemotherapy, infections, emergency procedures and hospitalizations, and increased costs of care. Therefore, malnutrition and sarcopenia represent a major clinical target in GI cancers. Interventions targeting malnutrition/sarcopenia should be implemented as early as possible in patients' pathways, these syndromes being reversible at early stages but not at late stages. A multidisciplinary assessment at diagnosis and therapeutic approach combining nutritional support and and adapted physical activity (APA) in addition to anticancer treatments should be systematically implemented in patients with advanced GI cancers. This type of intervention complies with the standards recommended by the National Cancer Institute (INCa) to promote the practice of physical activity during and after treatment in oncology.


Description:

All patients will receive usual care including: - Chemotherapy at the investigator's choice, - Outpatient clinical visits according to the regular schedule, - Tumor evaluation based on tumor marker serum levels, as appropriate, and TAP-CT with intravenous contrast injection every 8 weeks. Nutritional support will consist of: - A nutrition assessment by a dietician including a VAS of food intakes at baseline, at W4 and W8 (plus additional visits if required), - Nutritional intervention according to the Société Francophone de Nutrition Clinique et Métabolisme (SFNEP) guidelines (dietetic counseling for all patients ± oral supplementation, enteral tube feeding, and/or parenteral nutrition). Physical activity support will consist of physical condition assessed by International Physical Activity Questionnaire (IPAQ), performance status (ECOG PS), resting heart rate and blood pressure, 6-minute walking test (speed, fatigue), handgrip test, chair stand fitness test, get-up and go test, balance in single-leg and bipodal stance.


Recruitment information / eligibility

Status Completed
Enrollment 30
Est. completion date October 5, 2022
Est. primary completion date October 5, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Signed and dated informed consent, 2. Age = 18 years (no superior limit), 3. Histologically confirmed (1) non-colorectal cancer (esophagus, stomach, liver/bile ducts, pancreas, neuroendocrine carcinoma) or (2) colorectal with associated risk factors i.e. ECOG PS 2 (defining significant limitation in daily activities), and/or weight loss = 5% in 1 month or = 10% in 6 months (defining malnutrition/HAS 2019), 4. Advanced disease not amenable to surgery, radiation, or combined modality therapy with curative intent (previous resection of primary tumor allowed), treated with first-line chemotherapy for advanced disease (previous [neo]adjuvant chemo[radio]therapy allowed); or resectable/potentially resectable disease receiving a triplet chemotherapy regimen in a peri-operative setting (e.g. FOLFIRINOX, FLOT) (moderate risk at frailty score) 5. Patients able to attend for administration of chemotherapy, 6. Life expectancy = 3 months, 7. Registration in a National Health Care System (Couverture Maladie Universelle [CMU] included). Exclusion Criteria: 1. Other active non gastro-intestinal cancers 2. Any medical (including psychiatric, musculoskeletal, or neurological) condition contra-indicating exercise practice, 3. Pregnancy or breastfeeding, 4. Protected adults (individuals under guardianship by court order). Note: participation to another concomitant clinical trial is allowed, but the patient must inform the Investigator and get an authorization from the Sponsor.

Study Design


Related Conditions & MeSH terms

  • Carcinoma, Neuroendocrine
  • Colorectal With Associated Risk Factors
  • Non-colorectal Cancer (Esophagus, Stomach, Liver/Bile Ducts, Pancreas, Neuroendocrine Carcinoma)

Intervention

Other:
multidisciplinary assessment and intervention
early multidisciplinary assessment and intervention in addition to usual patient care

Locations

Country Name City State
France Institut Curie Paris

Sponsors (1)

Lead Sponsor Collaborator
Institut Curie

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary Program faisability Program feasibility will be satisfactory if = 80% of patients with advanced GI cancers included in the program complete the baseline, W4 and W8 assessments 12 months
Secondary Dimensions of EORTC QLQ-C30 EORTC QLQ-C30 completion 12 months
Secondary Fatigue measured by Visual Analogue Scale (VAS) Visual Analogue Scale (VAS) completion, a score form 0 to 10 will be given 12 months
Secondary Pain measured by VAS and analgesics consumption VAS completion and analgesics consumption report, a score form 0 to 10 will be given and report of analgesics consumption will be given by name and dose 12 months
Secondary Nutritional status/inflammation measure weight in kilograms, body mass index will be reported in BMI in kg/m^2, food intakes 12 months
Secondary Physical condition assessed International Physical Activity Questionnaire (IPAQ), 12 months
Secondary Geriatric assessment if age = 70 G8 score from 0 to 17 12 months
Secondary Chemotherapy tolerance assessed toxicities (using Common Terminology Criteria for Adverse Events [CTCAE v5.0]) 12 months
Secondary Progression Free Survival and Overall Survival Progression Free Survival and Overall Survival 12 months
Secondary Patient's satisfaction measured by VAS VAS completion with a score from 0 to 10 12 months