The Impact of PReOPerative Exercise and NutritionaL Optimization on Perioperative Outcomes for Patients Undergoing Treatment for Rectal Cancer: the PROPEL Trial

Purpose

The purpose of this study is to determine the feasibility of a prehabilitation program for participants diagnosed with rectal cancer undergoing neoadjuvant chemotherapy and/or radiation, followed by surgical resection. The names of the groups in this research study are: - Group A: Prehabilitation program - Group B: Usual Care

Conditions

  • Rectal Cancer
  • Colorectal Cancer
  • Rectal Cancer Stage II
  • Rectal Cancer Stage III

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Age greater than or equal to 18 years at time of enrollment. - English-Speaking. - Diagnosis of clinical stage II-III rectal cancer. - Planned, ongoing or just completed neoadjuvant treatment, including either 1) chemoradiation, 2) total neoadjuvant therapy (TNT), or 3) chemotherapy only; and anticipated surgical resection to follow. - Able to understand the study procedures, agree to participate in the study program, and voluntarily provide informed consent.

Exclusion Criteria

  • Distant metastatic disease known at the time of diagnosis. - Functional incapacity (i.e., incapable of performing exercise testing). - Comorbid conditions or cognitive/physical impairments that contraindicate exercise. - Currently undergoing treatment for a secondary primary tumor, in addition to primary rectal cancer. - Currently enrolled in a separate clinical trial that would prohibit them from performing the tasks instructed in this trial. - Currently participating in more than 60 minutes of moderate-to-vigorous aerobic exercise per week over the past month. This study targets insufficiently active persons to assess the effect of the described intervention, where additional exercise done regularly will contaminate the intervention effects.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Supportive Care
Masking
Single (Investigator)
Masking Description
Investigators blinded to block size

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Group A: Prehabilitation Program
Participants will be randomized in a 1:1 ratio using a permuted blocked design and stratified by neoadjuvant therapy received. Participants will complete the following: - In-clinic baseline visit with assessments - Virtual exercise sessions 3 days per week for 4 weeks. - IMN supplementation and daily multivitamin starting at 4 weeks of the preoperative phase. - Resection surgery per standard of care - In-clinic 30 day postoperative visit.
  • Behavioral: Prehabilitation Program
    A hybrid-based, prehabilitation regimen comprised of nutritional optimization (multivitamin and protein supplement shake) and virtual, aerobic and resistance exercise sessions with clinical exercise physiologists. Virtual exercise sessions will be performed via a HIPAA-compliant videoconferencing platform or by phone call. Mini-exercise cycle ergometer, dumbbells, and resistance bands will be provided and delivered to participant. Heart rate monitors and wi-fi enable tablet will be provided if needed.
No Intervention
Group B: Usual Care
Participants will be randomized in a 1:1 ratio using a permuted blocked design and stratified by neoadjuvant therapy received. Participants will complete the following: - In-clinic baseline visit with assessments - Resection surgery per standard of care - In-clinic 30 day postoperative visit - After completion of the study period, participants will be offered exercise equipment with an exercise instruction booklet.

Recruiting Locations

Brigham and Women's Hospital
Boston, Massachusetts 02215
Contact:
Joel Goldberg, MD
617-732-8460
JGOLDBERG1@PARTNERS.ORG

More Details

Status
Recruiting
Sponsor
Dana-Farber Cancer Institute

Study Contact

Jeffrey Meyerhardt, MD, MPH
617-632-6855
jeffrey_meyerhardt@dfci.harvard.edu

Detailed Description

This is a non-blinded, randomized control trial to determine the feasibility of a hybrid-model, prehabilitation program for participants diagnosed with rectal cancer undergoing neoadjuvant therapy (chemotherapy and/or radiation) before surgical resection. Investigators hope that prehabilitation will result in improved outcomes after surgery. Participants will be randomized into one of the study groups: Group A: prehabilitation program, or Group B: usual care. Randomization means that a participant is placed into a group by chance. The research study procedures include screening for eligibility, in-clinic visits, physical exams, exercise training, blood tests, and questionnaires. It is expected that about 40 participants will take part in this research study.