Exercise Training During Chemotherapy in Advanced Lung Cancer Patients
Research type
Research Study
Full title
Exercise Regimens Before and During Advanced Cancer Therapy: (EMBRACE): A pilot study to investigate the feasibility, tolerability and effect of exercise training on physical fitness before and during chemotherapy in advanced lung cancer patients.
IRAS ID
137102
Contact name
Sandy Jack
Contact email
Sponsor organisation
Southampton University Hospital NHS Foundation Trust
Research summary
We have previous demonstrated that neoadjuvant (prior to surgery )chemotherapy and chemoradiotherapy for upper and lower gastrointestinal cancers (stomach, gut and bowel) significantly impairs physical fitness objectively measured using cardiopulmonary exercise testing (CPET). Moreover this decreased in physical fitness is associated with increased mortality (death) and morbidity (complications)following major surgery. The literature shows that low fitness is associated with adverse surgical outcome. Cancer and chemotherapy are known to cause fatigue which is thought to be mediated via oxidative stress. Oxidative stress is an imbalance between the cellular damage causued by reactive oxygen species and the cellular ability to detoxify these species and repair the cellular damage. Oxidative stress is strongly linked to mechanisms of cellular energy and production. Aerobic exercise training has been shown to attenuate oxidative stress, to be safe in elderly cancer patients and improve health related quality of life (HRQL). We have pilot data in 51 rectal cancer patients in a contemporary controlled study (3:1 randomisation) showing that the reduced fitness caused by chemoradiotherapy can be improved with exercise training in following chemoradiotherapy prior to major surgery.
This proposal therefore aims to assess the feasibility and tolerability of exercise training before and during chemotherapy for 25 in patients with Non-Small Cell Lung Cancer (NSCLC) in 2/3 NHS Trusts compared. We will explore the effect of exercise training on physical fitness together with the effect on activity and Health Related Quality of Life (HRQL) at these time points. In a subgroup of patients we will also measure the effects of chemotherapy and exercise training on cellular energetics and oxidative stress. We aim to investigate whether it is possible to perform in-hospital exercise training prior to and during chemotherapy and then to explore the translation of this exercise training programme to home-based during the continued course of chemotherapy.
REC name
Yorkshire & The Humber - South Yorkshire Research Ethics Committee
REC reference
13/YH/0354
Date of REC Opinion
18 Nov 2013
REC opinion
Further Information Favourable Opinion