AzTrials
AzTrials

Breast CancerPhActHealthNCT07776951

Physical Activity and Healthy Aging: Promoting Cardio-metabolic Capacity to Fight Chronic Inflammation and Improve Outcomes in Breast Cancer Patients (PhActHealth Study)

A study testing Pre-habilitation exercise program in people with Breast Cancer, run by University of Milan at 2 sites in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

PhActHealth is a multicenter randomized controlled trial enrolling women with newly diagnosed luminal B or triple-negative breast cancer (BC) who are candidates for neoadjuvant therapy. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer
What is being tested?
Pre-habilitation exercise program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
126 participants
Where
2 sitesItaly
Study dates
1 Feb 2026to 28 Feb 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

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
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • being a patient with first diagnosis of primary BC;
  • luminal BC tumor subtype B defined as positive for estrogen and/or progesterone receptor expression, HER2 negative and high Ki-67; or triple Negative BC tumor subtype defined as negative for estrogen and/or progesterone receptor expression, HER2 negative, defined by the Pathology and Medical Oncology units as defined by the ESMO Guidelines Committee (referred to the American Society of Clinical Oncology/College of American Pathologists guidelines for assessment of hormone receptor (HR) status (i.e. ER and 4 PgR)25 and HER2 status, and by the International Ki-67 in Breast Cancer Working Group for Ki-67);
  • candidate for chemotherapy/immunotherapy neoadjuvant treatment;
  • signed informed consent for study participation;
  • declared being not engaged in any competitive or recreational physical activity.

Who cannot join

  • therapeutic modifications during the intervention period;
  • presence of chronic conditions (such as autoimmune diseases, neurodegenerative diseases, psychiatric disorders/cognitive disabilities, chronic obstructive pulmonary disease);
  • presence of any condition that significantly impairs the ability to perform exercise;
  • pregnancy/lactation/intention to initiate pregnancy;
  • prior chemotherapy or immunotherapy within the past three years;
  • high baseline physical activity level (i.e. performing exercise at a dose of 600 MET minutes a week or greater, according to the score of the International Physical Activity Questionnaire [IPAQ]).

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Elia M Biganzoli, Professor contact

+39 02503 19652

elia.biganzoli@unimi.it

Roberta Biciuffi, MSc contact

roberta.biciuffi@unimi.it

Italy2 sites, 2 recruiting
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

    Milan

    Ornella Garrone, ornella.garrone@policlinico.mi.it

    Not yet recruiting
  • University of Urbino "Carlo Bo"

    Urbino

    Elena Barbieri, elena.barbieri@uniurb.it

    Recruiting

Other trials in Italy

About this study

Official title: PhActHealth - Physical Activity and Healthy Aging: Fighting Low Grade Chronic Inflammation to Put Out the Cardio-oncologic Risk

PhActHealth is a multicenter randomized controlled trial enrolling women with newly diagnosed luminal B or triple-negative breast cancer (BC) who are candidates for neoadjuvant therapy. The study aims to investigate the effects of a preoperative, unsupervised exercise training program on exercise capacity, as well as on immune response, autonomic nervous system (ANS) regulation, cardiovascular health, and tumor aggressiveness prior to surgical removal.

Participants are randomly assigned to either an intervention group or a control group. All patients receive lifestyle counseling, while those in the intervention group additionally follow a personalized aerobic and resistance exercise program throughout the neoadjuvant treatment period before surgery.

The primary outcome is the improvement in exercise capacity. The secondary outcomes are tumor-specific and systemic responses to the intervention, evaluated by analyzing molecular, metabolic, and inflammatory markers, as well as clinical and functional parameters.

Read the detailed description

BC is strongly affected by systemic inflammation and immune alterations. Exercise has been demonstrated improving cardiometabolic health and reducing inflammatory markers in patients with oncology diseases. However, its role in the pre-operative setting, during neoadjuvant therapy, still remains poorly defined. The PhActHealth study investigates whether a structured pre-operative exercise program can improve functional capacity and modulate tumor and systemic biological markers in breast cancer patients, before surgery, and improve survival and quality of life, after surgery.

The PhActHealth study aims to comprehensively investigate the impact of a pre-operative, remotely monitored exercise training program in patients with BC, with a dual focus: (i) Improving exercise capacity; (ii) Exploring the potential modulation of biomarkers involved in tumor progression, systemic inflammation, and immune response by integrating functional assessments, biological analyses, and patient-reported outcomes.

Women with operable BC who are candidates for neoadjuvant therapy are enrolled after confirmation of eligibility criteria, and randomly assigned to either an intervention arm (IA) or a control arm (CA).

The intervention begins with the initiation of systemic therapy and continues until the planned date of surgery; then, two follow-ups are performed. At baseline, patients enrolled in both study arms receive lifestyle counseling, with specific recommendations for maintaining an active lifestyle based on the currently available international guidelines. In addition to lifestyle counseling, participants enrolled in the IA receive a personalized pre-habilitation exercise training program - which is undertaken autonomously and remotely monitored - until one week before surgery. Then, all participants undergo the planned surgical treatment, followed according to routine clinical practice, during which two follow-ups are scheduled.

The primary outcome is peak exercise capacity while secondary outcomes are tumor response and proliferation, immune and angiogenesis markers in tumor tissue, systemic inflammatory and metabolic biomarkers, body composition, autonomic function, and quality of life, overall and disease-free survival, as well as other functional and psychosocial parameters.

At baseline and before surgery, urine, blood, stool, and tumor biopsy samples are collected, and all primary and secondary outcomes are assessed, except overall and disease-free survival, which are assessed at the follow-up time-points, and quality of life which is assessed at all time-points.

Conditions
Breast Cancer
Being tested
Pre-habilitation exercise program
Keywords
chronic inflammation, luminal B breast cancer, Triple Negative Breast Cancer (TNBC), lifestyle intervention, exercise, METs
Medical subject headings
Breast Neoplasms, Triple Negative Breast Neoplasms, Motor Activity

What participants receive

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

  • Pre-habilitation exercise programBehavioural

    Participants undertake a 16-week personalized pre-habilitation exercise training program as follows:

    • Aerobic training: five times per week with an initial session duration set at 45 minutes.The initial target intensity is set at 40% of the Heart Rate Reserve (HRR). Both duration and intensity are progressively increased based on individual exercise tolerance, aiming for an intensity of approximately 60% HRR and a duration of 60 minutes per session.
    • Resistance training: twice per week, ensuring at least 24-48 hours of recovery between sessions. Patients follow the prescribed number of sets and repetitions demonstrated in in the video tutorials provided by the study staff.
Study groups in NCT07776951
Study groupRoleWhat they receive
Personalized pre-habilitation exercise training program and lifestyle counselingExperimentalParticipants receive specific recommendations for maintaining an active lifestyle, with additional guidance on nutritional habits, stress management, substance use, alcohol consumption, smoking, and sleep. Furthermore, participants are asked to wear a wrist-worn wearable device for the entire duration of the intervention in order to monitor their adherence to the intervention program: a 16-week personalized pre-habilitation exercise training, that includes a combination of aerobic endurance exercises, aimed at enhancing exercise capacity, and muscle-strengthening exercises, aimed at increasing muscle mass and strength.
Receives: Behavioral: Pre-habilitation exercise program
Lifestyle counselingNo interventionParticipants receive specific recommendations for maintaining an active lifestyle, with additional guidance on nutritional habits, stress management, substance use, alcohol consumption, smoking, and sleep. Furthermore, participants are asked to wear a wrist-worn wearable device for the entire duration of the intervention in order to track physical activity habits.

What is being measured

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

  1. Exercise capacity

    Change in metabolic equivalents of task (METs) at peak exercise intensity, measured during a maximal exercise stress test.

    Measured: Baseline and 6 months

Secondary outcomes (19)
  1. Pathologic Complete Response (pCR)

    Defined as the absence of residual invasive cancer in the breast and axillary lymph nodes at surgery (ypT0/is ypN0). Results will be reported as the proportion of participants achieving pCR (%)

    Measured: At surgery, following completion of neoadjuvant treatment

  2. Residual Cancer Burden (RCB)

    Assessed according to the validated RCB index calculated from primary tumor dimensions, tumor cellularity, and nodal involvement at surgery. Results will be reported as both continuous RCB score (unitless index) and categorical RCB class (RCB-0, RCB-I, RCB-II, RCB-III)

    Measured: At surgery, following completion of neoadjuvant treatment

  3. Stromal Tumor-Infiltrating Lymphocytes (sTILs)

    Assessed on hematoxylin and eosin (H\&E)-stained sections from diagnostic biopsies and surgical specimens according to the recommendations of the International Immuno-Oncology Biomarker Working Group. Results are reported as the percentage (%) the stromal area within the borders of the invasive tumor occupied by mononuclear inflammatory cells (predominantly lymphocytes and plasma cells).

    Measured: Baseline diagnostic biopsy and surgery

  4. Tumor Angiogenesis

    Assessed by immunohistochemical evaluation of tumor-associated microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression in tumor tissue. MVD is quantified using an endothelial marker such as CD31 or CD34 and reported as the number of immunostained microvessels per field or per mm². VEGF expression is reported as the percentage (%) of positive tumor cells and staining intensity.

    Measured: Baseline diagnostic biopsy and surgery

  5. Tumor tissue Insulin-like growth factor 1 (IGF-1) expression

    Evaluated by immunohistochemistry (IHC) and expressed as the percentage (%) of positive tumor cells in diagnostic biopsies and surgical specimens. Expression is quantified according to the percentage of positive tumor cells and staining intensity, using an H-score or an equivalent validated scoring system.

    Measured: Baseline diagnostic biopsy and surgery

  6. IGF-1 receptor expression (IGF-1R)

    Evaluated by immunohistochemistry (IHC) and measured as the percentage (%) of positive tumor cells staining intensity, and cellular localization, using an H-score or an equivalent validated scoring system.

    Measured: Baseline diagnostic biopsy and surgery

  7. Ki-67 expression

    Measured as the percentage (%) of positively stained tumor cells on diagnostic biopsies and surgical specimens. In hormone receptor-positive tumors, the proportion of patients achieving a post-treatment Ki-67 ≤2.7% will also be explored as an indicator of complete cell-cycle arrest. In TNBC, Ki-67 changes will be considered exploratory and interpreted together with pCR and RCB. In a subset of cases, transcript-level changes in proliferation- and immune-related genes will be explored using RNA in situ hybridization with spatial resolution.

    Measured: Baseline diagnostic biopsy and surgery

  8. Lipid Profile

    Change in total cholesterol (mg/dL), High-density lipoprotein (HDL) cholesterol (mg/dL), Low-density lipoprotein (LDL) cholesterol (mg/dL), triglycerides (mg/dL), assessed in the blood

    Measured: Baseline and 6 months

  9. Blood glucose

    Assessed in blood samples and expressed in milligrams per deciliter (mg/dL).

    Measured: Baseline and 6 months

  10. Glycated hemoglobin (HbA1c)

    Assessed in blood samples and expressed in millimoles per mole (mmol/mol)

    Measured: Baseline and 6 months

  11. Insulin

    Assessed in blood samples and expressed in milli-international units per liter (mIU/L).

    Measured: Baseline and 6 months

  12. Liver function markers

    Change in Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) assessed in the blood (U/L)

    Measured: Baseline and 6 months

  13. C-reactive protein (CRP)

    Change in C-reactive protein (CRP) (mg/dL), assessed in the blood

    Measured: Baseline and 6 months

  14. High-sensitivity C-reactive protein (hs-CRP)

    Change in High-sensitivity C-reactive protein (hs-CRP) (mg/dL), assessed in the blood

    Measured: Baseline and 6 months

  15. Interleukin-6 (IL-6)

    Change in Interleukin-6 (IL-6) (pg/mL), assessed in the blood

    Measured: Baseline and 6 months

  16. Neutrophil-to-lymphocyte ratio (N/L)

    Change in Neutrophil-to-lymphocyte ratio (N/L), calculated from blood neutrophil and lymphocyte counts

    Measured: Baseline and 6 months

  17. Platelet-to-lymphocyte ratio (P/L)

    Change in platelet-to-lymphocyte ratio (P/L), calculated from blood platelet and lymphocyte counts

    Measured: Baseline and 6 months

  18. Thyroid Function

    Change in Thyroid-stimulating hormone (TSH) assessed in the blood (mIU/L)

    Measured: Baseline and 6 months

  19. Epigenetic markers

    Changes in DNA methylation and miRNA expression will be assessed using validated molecular techniques. DNA methylation will be evaluated by genome-wide methylation arrays and/or bisulfite pyrosequencing, while miRNA expression will be quantified by reverse transcription quantitative PCR (RT-qPCR).

    Measured: Baseline and post-intervention/pre-surgery

Timeline

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

  1. First posted20 Aug 2026
  2. Study start1 Feb 2026
  3. Primary completion28 Feb 2028 (estimated)
  4. Study completion28 Feb 2029 (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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants are randomized into two arms: assessed before and after the intervention with personalized pre-habilitation exercise training program and lifestyle advice.
Masking
None (open label)
Enrolment
126 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07776951
Sponsor's protocol ID
PhActHealth
Other IDs
G53D12001480006
Acronym
PhActHealth
Status last verified
Jul 2026
First submitted
27 May 2026
Last updated
20 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Pre-habilitation exercise program in people with Breast Cancer, run by University of Milan at 2 sites in Italy.

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 5 inclusion and 6 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: looking for participants now, as of the sponsor's last update on 20 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Italy. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Elia M Biganzoli, Professor (+39 02503 19652, elia.biganzoli@unimi.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Exercise capacity (time frame: Baseline and 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 20 Aug 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in