Low-moderate Intensity Pedaling During Immunotherapy Administration

Overview

The purpose of this study is to determine the feasibility pedaling using an under-the desk bike during immunotherapy infusions. Also, the study hopes to evaluate how pedaling impacts quality of life and treatment response biomarkers. Lastly, the study will evaluate the relationships between treatment response and muscle mass which is evaluated with computerized tomography (CT) scans.

Full Title of Study: “Evaluating the Effects of Low-moderate Intensity Pedaling During Immunotherapy Administration on Immune Biomarkers and Quality of Life”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: October 2020

Interventions

  • Behavioral: Pedaling Group
    • Participants will pedal at low-moderate intensity using a stationary pedal ergometer concurrent to their immunotherapy infusion (30 minutes).

Arms, Groups and Cohorts

  • Experimental: Pedaling Group
    • During their 30 minute immunotherapy infusions, participants will pedal using a stationary cycle ergometer. Participants will be allowed to determine their pedaling intensity and cadence, however, will be encouraged to reach the established goal intensity level. A research personnel will monitor the patient’s heart rate, blood pressure, and RPE at baseline and every 10 minutes throughout the pedaling session. Participants will also have treatment response biomarkers gathered at baseline and before and within 10 minutes of completing their first and fourth immunotherapy infusions. Lastly, participants will complete both a physical activity questionnaire and a quality of life questionnaire at baseline and following their fourth treatment.

Clinical Trial Outcome Measures

Primary Measures

  • Feasibility of Pedaling Concurrent to Immunotherapy Infusions
    • Time Frame: 12 weeks
    • The number of completed pedaling sessions as well as the ability of patients to meet goal pedaling intensities will be evaluated.

Secondary Measures

  • Quality of life scores
    • Time Frame: 12 weeks
    • Quality of life markers will be assessed using the Quality of Life Questionnaire – Core 30, at baseline and following their fourth immunotherapy treatment.
  • Treatment response biomarkers
    • Time Frame: 12 weeks
    • Treatment response biomarkers (check point inhibitors, functional T and B cell subsets, pro and anti-inflammatory monocyte subsets, and soluble inflammatory mediators) will be drawn before and immediately following first and fourth immunotherapy treatments. All biomarkers are available as either part of the MILLIPLEX® MAP Human High-sensitivity T-cell Assay or the ProcartaPlex Human Immuno-Oncology Checkpoint Panel. All assays will be run according to the manufacturer’s recommended protocols on a Luminex FlexMAP 3D system with concentrations calculated based on 7-point standard curves.
  • CT-derived sarcopenia rates
    • Time Frame: 12 weeks
    • CT images will be gathered at the time of diagnosis and following completion of immunotherapy treatments. Patient’s CT scans will be uploaded to a medical image analysis software (SliceOmatic), which allows for the evaluation of body composition, focusing on sarcopenia or muscle depletion.

Participating in This Clinical Trial

Inclusion Criteria

  • Minimum age of 18 – Renal Cell Carcinoma, cutaneous malignancies (Melanoma, Merkel Cell Carcinoma or Squamous Cell CA) or bladder cancer. – Planned intravenous immunotherapy treatment (Pembrolizumab, Nivolumab, or combinations as clinically indicated by standards of care). – ECOG Performance Status of Grade 0-2 – No uncontrolled cardiac disease Exclusion Criteria:

  • ECOG Performance Status of Grade 3-5 – Severe cardiac history or comorbidities (i.e. heart failure, clinically significant aortic stenosis, history of cardiac arrest, have a cardiac defibrillator, uncontrolled angina, uncontrolled arrhythmias, major heart surgery, stroke, or pulmonary embolus). – Chest pain or severe shortness of breath at rest or with physical activity. – Orthopedic impediments to exercise (i.e. joint immobility or lower extremity lymphedema). – Limitations to sustained exercise (i.e. bone metastases in the femur neck). – Severe arthritis (i.e. osteoarthritis or rheumatoid arthritis). – Patients will be excluded from study if their immunotherapy treatment requires the use of sedating antihistamines prior to treatment.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Rush University Medical Center
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Timothy M Kuzel, MD, Principal Investigator, Rush University Medical Center

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