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Advanced Lung CarcinomaBREATHNCT06374160

Exercise in Patients With Advanced Non-small Cell Lung Cancer

A study testing Exercise intervention in people with Advanced Lung Carcinoma and First Line Treatment, run by University Hospital, Essen at 1 site in Germany.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Lung cancer is one of the most common types of cancer in Germany, with 56,839 new cases and 45,072 deaths annually. Approximately 70% of patients with non-small cell lung cancer (NSCLC) are diagnosed at an advanced stage and suffer from comorbidities and symptoms such as fatigue, tiredness, and loss of strength. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Exercise intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
104 participants
Where
1 siteGermany
Study dates
1 May 2024to 31 Aug 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with histologically confirmed non-small cell lung carcinoma in UICC stages IIIB and IV
  • First- or second-line therapy (inclusion up to 28 days after the first cycle) in palliative intention
  • Age ≥ 18 years
  • Signed informed consent

Who cannot join

  • Severe cardiopulmonary disease (EF<30%)
  • Newly occurring or progressive uncontrolled CNS (central nervous system) metastases
  • Expected life expectancy < 3 months
  • Bone metastases with acute risk of fracture
  • ECOG (Eastern Cooperative Oncology Group) performance status > 2
  • Acute pulmonary embolism
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  • Acute myocardial infarction
  • Requiring surgery for aortic aneurysm
  • Tension pneumothorax
  • Lack of proficiency in the German language
  • Active infection

Trial locations and contacts

1 site in 1 country.

Nico De Lazzari, M. Sc. contact

+49 201 / 723-82035

nico.delazzari@uk-essen.de

Mitra Tewes, PD. Dr. contact

+49 201 723 7262

mitra.tewes@uk-essen.de

Germany1 site
  • West German Cancer Center (Department of Palliative medicine and Department of Medical Oncology), University Hospital Essen

    Essen, North Rhine-Westphalia, 45147

    Mitra Tewes, PD. Dr., mitra.tewes@uk-essen.de

    Nico De Lazzari, M. Sc., +49 201 723-82035, nico.delazzari@uk-essen.de

Other trials in Germany

About this study

Official title: Better Symptom Control With Exercise in Patients With Advanced Non-small Cell Lung Cancer

Lung cancer is one of the most common types of cancer in Germany, with 56,839 new cases and 45,072 deaths annually. Approximately 70% of patients with non-small cell lung cancer (NSCLC) are diagnosed at an advanced stage and suffer from comorbidities and symptoms such as fatigue, tiredness, and loss of strength. The standard first-line treatment for metastatic NSCLC includes platinum-based chemoimmunotherapy followed by immunotherapy maintenance. Exercise can have positive effects on symptoms such as shortness of breath, fatigue, quality of life, and physical fitness. However, there is a lack of current scientific evidence for the effectiveness of exercise in advanced lung cancer patients. No current trial investigated exercise in advanced NSCLC receiving immunotherapy so far.

The BREATH-study is a prospective 3-arm randomized controlled trial (RCT). In total, the investigators plan to recruit 104 patients. A 2:1:1 randomization will be performed with three study groups: a control group and two exercise therapy groups (strength+endurance exercise/only endurance exercise). One group receives individual endurance training and the other group a combination of individual endurance and strength training. Both treatment groups will be treated twice a week for 12 weeks. The control group will initially receive standard treatment without exercise for 12 weeks and will then be randomized into one of the other two study groups with exercise twice a week for 12 weeks. This approach allows for a sufficiently large sample for comparisons between exercise therapy and the control group, as well as between the two exercise therapy approaches.

The primary aim is to investigate the impact of exercise on V02peak. Secondarily endpoints aim to investigate changes in physical function, patient related outcomes and cardiac function before and after exercise.

Being tested
Exercise intervention
Medical subject headings
Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Exercise interventionBehavioural

    Exercise

Study groups in NCT06374160
Study groupRoleWhat they receive
Arm A (endurance training + strength training)ExperimentalFrequency: 2 supervised exercise sessions per week. Session Breakdown: Duration: 60 minutes per session. Aerobic Endurance Training: 20 minutes. Strength Training: 40 minutes. Aerobic Interval Training: Set at 50% of maximal workload based on spiroergometry. Five sets of 2 minutes of exertion; 5 sets of 1 minute of recovery; Total exertion time: 20 minutes Strength Training: Muscle Groups Targeted: Major muscle groups. Sets and Repetitions: 2 sets with 8-12 repetitions. Training Intensity: Range: 50-80% of 1-RM (1-repetition maximum)
Receives: Behavioral: Exercise intervention
Arm B (endurance exercise)ExperimentalFrequency: 2 supervised exercise sessions per week. Session Breakdown: Duration: Approximately 30 minutes. Focus: Aerobic endurance training. Followed by 10 minutes of Respiratory therapy. Endurance Training: Method: Intervals for a balance between exertion and recovery. Intensity: Set at 50% of maximal workload based on spiroergometry.
Receives: Behavioral: Exercise intervention
Arm C (Usual Care)No interventionThe control group receives a one-time sports consultation with general information about daily activities and sports participation, as well as individual training recommendations. After the 12 weeks, the control group will be randomized into one of the exercise therapies.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximum oxygen uptake (VO2 peak [ml/min/kg])

    The primary goal is to achieve an improvement in performance (VO2 peak[ml/min/kg]) from T0 (enrolment) to T1 (12 weeks) through exercise compared to the standard treatment. The one-sided alternative hypothesis of a larger improvement in the two treatment groups compared to the control group will be tested statistically as a confirmatory analysis.

    Measured: assessed at Baseline, after 12 weeks and 24 weeks of enrolment

Secondary outcomes (29)
  1. Functional Assessment of Chronic Illness Therapy - Fatigue (FACT-F)

    The FACT-F is a 13-item questionnaire to assess fatigue in cancer patients. Subscale are physical well-being, social/family well-being, emotional well-being, functional well-being and the fatigue subscale. Based on the subscale the FACIT-F trial outcome index (TOI) Score range 0-108, FACT-G total score (Score range 0-108) and FACIT-F total score (Score range 0-160) can be calculated. The higher the score, the better the Quality of Life.

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  2. European Organisation for Research and Treatment of Cancer (EORTC QLQ C30)

    The EORTC QLQ Core Questionnaire is a 30-item instrument meant to assess some of the different aspects that define the quality of life of cancer patients (e.g., physical function, emotional function, symptom scales, and Quality of Life). High scores for functional scales (score 0-100) represent a high level of functioning, high scores for the global health status represent a high quality of life (score 0-100), high scores for symptom scales (score 0-100) represent a high level of symptomatology.

    Measured: assessed at baseline after 12 weeks and 24 weeks of enrolment

  3. European Organisation for Research and Treatment of Cancer Lung cancer module (EORTC-LC13)

    The LC13 is a modular supplement to the EORTC-C30 for assessment of symptoms in clinical lung. cancer trials. The scoring range is between 0 to 100, a high score indicating a high level of symptomatology.

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  4. Arterial blood pressure

    Change during study participation (mmHg)

    Measured: assessed at Baseline, after 12 weeks and 24 weeks of enrolment

  5. Change in ECG

    Changes in 12-lead resting ECG, including PQ [ms], QRS [ms], and QT [ms] intervals

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  6. Adherence to exercise intervention

    The exercise physiologist monitored adherence to the supervised sessions. Based on the absolute numbers of scheduled exercise sessions, both absolute and percentage-based adherence can be calculated and compared between study arms.

    Measured: Through study completion, an average of 12 weeks

  7. Drop-out rate

    All withdrawals will be considered as dropouts, with reasons noted. Compare the total number of dropouts in each study arm. This provides a straightforward comparison of the raw dropout counts between groups. Also, calculate the percentage of participants who dropped out in each study arm relative to the total number of participants initially assigned to that arm. This allows for a comparison of dropout rates relative to the initial sample size and compared between study arms.

    Measured: Through study completion, an average of 12 weeks

  8. Recruitment rate

    The recruitment rate quantifies the speed of participant enrollment for a study.

    Measured: At Baseline

  9. Serious Adverse Event/Adverse Events

    Safety analyses will be based on Adverse Events (AEs), Serious Adverse Events (SAEs) after the Common Terminology Criteria for Adverse Events (CTCAE) v5.0

    Measured: Through study completion, an average of 12 weeks

  10. Therapy response

    Therapy response in the next computer tomography (analogous to RECIST v1.1)

    Measured: Baseline and after 12 weeks

  11. Treatment Toxicity

    Treatment toxicity encompasses the adverse effects experienced by individuals undergoing chemotherapy and exercise regimens concurrently. These effects may manifest as physical symptoms such as fatigue, nausea, muscle weakness, and decreased immune function, which can impact overall well-being and treatment adherence. Monitoring and managing toxicity levels are crucial to ensure patient safety and optimize treatment outcomes. Additionally, integrating exercise interventions alongside chemotherapy may pose unique challenges, as physical activity can exacerbate certain side effects or interact with treatment efficacy. Therefore, careful monitoring and personalized exercise prescriptions are essential to mitigate toxicity risks and enhance the overall tolerability and effectiveness of combined therapy approaches. Toxicity will be reported with CTCAE v5.0

    Measured: assessed at baseline after 12 weeks and 24 weeks of enrolment

  12. Treatment scheme

    Change in dose or frequency during trial participation

    Measured: assessed at baseline after 12 weeks and 24 weeks of enrolment

  13. NT-pro-BNP

    Concentration of N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP), measured in picograms per milliliter (pg/mL) of blood

    Measured: Up to 24 weeks

  14. High sensitive troponin I

    Concentration of troponin I in nanograms per milliliter [ng/mL] of blood.

    Measured: Up to 24 weeks

  15. Erythrocytes

    The amount of Erythrocytes per liter [/pl]

    Measured: Up to 24 weeks

  16. Hemoglobin

    Concentration of hemoglobin in the blood, measured in grams per deciliter (g/dL)

    Measured: Up to 24 weeks

  17. Leukocytes

    Count of leukocytes per nanoliter [ /nl]

    Measured: Up to 24 weeks

  18. Lymphocytes

    Count of lymphocytes per nanoliter [ /nl]

    Measured: Up to 24 weeks

  19. Neutrophils

    Count of neutrophils per nanoliter [ /nl]

    Measured: Up to 24 weeks

  20. CRP

    Concentration of C-reactive protein (CRP) in the blood, measured in milligrams per deciliter [mg/dL]

    Measured: Up to 24 weeks

  21. CYRFRA 21-1

    Concentration of cytokeratin-19 fragment (CYFRA 21-1) in nanograms per milliliter [ng/mL] of blood

    Measured: Up to 24 weeks

  22. Physical function (Hypothetical One-repetition maximum)

    Leg press [kg.], Latissimus pulldown [kg.], bench press [kg.], Crunch [kg.], Leg curl [kg.], Back extension [kg.]

    Measured: assessed at baseline after 12 weeks and 24 weeks of enrolment

  23. Blood gas analysis pH value

    pH value

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  24. Blood gas analysis (PAO2)

    Partial pressure of oxygen in arterial blood (PAO2 [mmHg])

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  25. Blood gas analysis (SaO2)

    Arterial oxygen saturation, measured as a percentage (SaO2 [%])

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  26. Blood gas analysis (PCO2)

    Partial pressure of carbon dioxide in arterial blood PCO2 [mmHg]

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  27. Blood gas analysis (BE)

    Base excess (BE) represents the amount of excess or deficit of base (primarily bicarbonate, HCO3-) in the blood [mmol/l]

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  28. Blood gas analysis (HCO3)

    Bicarbonate concentration in the blood HCO3 [mmol/l]

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

  29. Blood gas analysis (SBCe)

    Bicarbonate Concentration in the extracellular fluid SBCe [mmol/l]

    Measured: assessed at baseline, after 12 weeks and 24 weeks of enrolment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Apr 2024
  2. Study start1 May 2024 (estimated)
  3. Primary completion30 Apr 2026 (estimated)
  4. Study completion31 Aug 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Crossover
Model description
BREATH is a prospective 3-arm 2:1:1 randomized controlled trial (RCT). The first arm represents the control group, which will receive the standard treatment for the first 12 weeks (recommendations for physical activity during cancer treatment). The other two arms represent the exercise groups, one group will receive individualized endurance training and the other group a combination of individualized endurance and strength training. All arms will be treated for 12 weeks. Afterwards, the patients in the control group are randomized to one of the other two study arms and then also treated twice for 12 weeks.
Masking
None (open label)
Enrolment
104 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06374160
Sponsor's protocol ID
70115371
Acronym
BREATH
Status last verified
Apr 2024
First submitted
10 Apr 2024
Last updated
18 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: We will publish a study protocol, including the statistical analysis plan, at an international peer-reviewed journal

Publications

  • De Lazzari N, Wiesweg M, Gotte M, Franco J, Mincu RI, Jager J, Huessler EM, Kuklik N, Stang A, Totzeck M, Tewes M. Improving aerobic capacity in patients with advanced non-small cell lung cancer: study protocol of the 3-armed randomized controlled BREATH trial. Trials. 2026 Jan 17;27(1):88. doi: 10.1186/s13063-025-09416-2.

    PubMed 41546104

Questions about this trial

What is this clinical trial studying?

A study testing Exercise intervention in people with Advanced Lung Carcinoma and First Line Treatment, run by University Hospital, Essen at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 18 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Nico De Lazzari, M. Sc. (+49 201 / 723-82035, nico.delazzari@uk-essen.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximum oxygen uptake (VO2 peak [ml/min/kg]) (time frame: assessed at Baseline, after 12 weeks and 24 weeks of enrolment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06374160, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Apr 2024.

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