Grant Details
Grant Number: |
5R01CA206196-04 Interpret this number |
Primary Investigator: |
Caan, Bette |
Organization: |
Kaiser Foundation Research Institute |
Project Title: |
Resistance Training to Reduce Chemotoxicity in Colon Cancer |
Fiscal Year: |
2020 |
Abstract
ABSTRACT
The proportions of fat mass (FM) and muscle mass (MM) in the body may have important implications for
calibration of chemotherapy in patients with colon cancer (CC). Chemotherapy dosing is currently based on
body surface area (BSA), which is derived from information on height and weight. Body weight or Body Mass
Index (BMI), especially among cancer patients, is not an accurate measure of FM or MM. Given this inability to
predict FM or MM, dosing by BSA may lead to underdosing (which may impact cancer-specific and overall
survival) or overdosing (leading to dose-limiting toxicity [DLT] defined as toxicity from chemotherapy that
requires subsequent reductions in or discontinuation of life-saving treatment). Results have shown that those
with low MM, or sarcopenia, have a higher risk of DLT than those with normal MM. DLT impacts dose intensity
and may compromise efficacy of chemotherapy. We propose to examine the effects of a randomized clinical
trial conducted during chemotherapy of home based resistance training (RT) versus a waitlist control on DLT.
Participants will be 180 newly diagnosed Stage II and III CC patients from Kaiser Permanente of Northern
California (KPNC), the Penn State Cancer Institute (PSCI), and the Dana Farber Cancer Institute (DFCI). The
intervention will begin during the first 6 weeks of chemotherapy and continue through the completion of
treatment. Specifically, we will examine between group differences for resistance training versus weight list
control for dose intensity and grade 3 and 4 toxicities as well as changes in MM and changes in inflammatory
markers. Since approximately 40-45% of newly diagnosed CC patients have sarcopenia at diagnosis, we will
examine if the benefits of exercise are greater for those who have low MM compared to normal MM. We will
also examine specific inflammatory markers (e.g. CRP, IL-6 and TNF-RII) as potential biomarkers of baseline
MM, and determine how they change in response to RT. To determine effects of change of MM on
chemotherapy-specific drug clearance, we will examine the impact of RT induced body composition changes
on the pharmacokinetics (PK) of 5-FU and oxaliplatin. If RT helps to reduce DLT and MM and inflammatory
markers can identify those patients most-likely to benefit from tailored exercise guidelines, then assessment of
these parameters can be used to help target high risk patients. Given that DLT is a common problem and there
are large numbers of newly diagnosed CC patients with undetected sarcopenia, many of whom may require
dose reductions due to low MM, this study has the potential to have a large impact on clinical care and improve
prognosis of colon cancer.
Publications
Dietary quality and chemotherapy-induced peripheral neuropathy in colon cancer.
Authors: Compton S.L.E.
, Yang S.
, Madere J.
, Weltzien E.K.
, Caan B.J.
, Meyerhardt J.A.
, Schmitz K.H.
, Brown J.C.
.
Source: Cancer, 2024-10-05 00:00:00.0; , .
EPub date: 2024-10-05 00:00:00.0.
PMID: 39369275
Related Citations
Effect of resistance training on physical function during chemotherapy in colon cancer.
Authors: Brown J.C.
, Yang S.
, Compton S.L.E.
, Campbell K.L.
, Cespedes Feliciano E.M.
, Quinney S.
, Sternfeld B.
, Caan B.J.
, Meyerhardt J.A.
, Schmitz K.H.
.
Source: Jnci Cancer Spectrum, 2024-07-01 00:00:00.0; 8(4), .
PMID: 39012500
Related Citations
Postoperative chemotherapy relative dose intensity and overall survival in patients with colon cancer.
Authors: Brown J.C.
, Meyerhardt J.A.
, Yang S.
, Caan B.J.
.
Source: Cancer Chemotherapy And Pharmacology, 2024-03-23 00:00:00.0; , .
EPub date: 2024-03-23 00:00:00.0.
PMID: 38520557
Related Citations
Effect of home-based resistance training on chemotherapy relative dose intensity and tolerability in colon cancer: The FORCE randomized control trial.
Authors: Caan B.J.
, Brown J.C.
, Lee C.
, Binder A.M.
, Weltzien E.
, Ross M.C.
, Quesenberry C.P.
, Campbell K.L.
, Cespedes Feliciano E.M.
, Castillo A.
, et al.
.
Source: Cancer, 2024-01-24 00:00:00.0; , .
EPub date: 2024-01-24 00:00:00.0.
PMID: 38265970
Related Citations
Advances in Adherence Reporting of Resistance Training in a Clinical Trial during Adjuvant Chemotherapy for Colon Cancer.
Authors: Campbell K.L.
, Brown J.C.
, Lee C.
, Weltzien E.
, Li J.
, Sternfeld B.
, Campbell N.
, Vaughan M.
, Fedric R.
, Meyerhardt J.A.
, et al.
.
Source: Medicine And Science In Sports And Exercise, 2024-01-18 00:00:00.0; , .
EPub date: 2024-01-18 00:00:00.0.
PMID: 38233992
Related Citations
D3-creatine dilution, computed tomography and dual-energy X-ray absorptiometry for assessing myopenia and physical function in colon cancer: A cross-sectional study.
Authors: Cheng E.
, Caan B.J.
, Cawthon P.M.
, Evans W.J.
, Hellerstein M.K.
, Shankaran M.
, Campbell K.L.
, Binder A.M.
, Sternfeld B.
, Meyerhardt J.A.
, et al.
.
Source: Journal Of Cachexia, Sarcopenia And Muscle, 2023-10-30 00:00:00.0; , .
EPub date: 2023-10-30 00:00:00.0.
PMID: 37899757
Related Citations
Body Composition, Relative Dose Intensity, and Adverse Events among Patients with Colon Cancer.
Authors: Cheng E.
, Caan B.J.
, Cawthon P.M.
, Evans W.J.
, Hellerstein M.K.
, Shankaran M.
, Nyangau E.
, Campbell K.L.
, Lee C.
, Binder A.M.
, et al.
.
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2023-10-02 00:00:00.0; 32(10), p. 1373-1381.
PMID: 37450841
Related Citations
The association of abdominal adiposity with premature discontinuation of postoperative chemotherapy in colon cancer.
Authors: Brown J.C.
, Meyerhardt J.A.
, Cespedes Feliciano E.M.
, Cheng E.
, Caan B.J.
.
Source: Clinical Nutrition (edinburgh, Scotland), 2022 Jul; 41(7), p. 1600-1604.
EPub date: 2022-05-27 00:00:00.0.
PMID: 35671612
Related Citations
Recruitment strategies and design considerations in a trial of resistance training to prevent dose-limiting toxicities in colon cancer patients undergoing chemotherapy.
Authors: Caan B.J.
, Meyerhardt J.A.
, Brown J.C.
, Campbell K.L.
, Cespedes Feliciano E.M.
, Lee C.
, Ross M.C.
, Quinney S.
, Quesenberry C.
, Sternfeld B.
, et al.
.
Source: Contemporary Clinical Trials, 2020-12-07 00:00:00.0; 101, p. 106242.
EPub date: 2020-12-07 00:00:00.0.
PMID: 33301991
Related Citations
Sarcopenia in aging, obesity, and cancer.
Authors: Ligibel J.A.
, Schmitz K.H.
, Berger N.A.
.
Source: Translational Cancer Research, 2020 Sep; 9(9), p. 5760-5771.
PMID: 33163373
Related Citations