A Personalized Physical Activity Program With Activity Trackers and a Mobile Phone App for Patients With Metastatic Breast Cancer: Protocol for a Single-Arm Feasibility Trial

Delrieu, Lidia; Pérol, Olivia; Fervers, Béatrice; Friedenreich, Christine M.; Vallance, Jeff K.; Febvey-Combes, Olivia; Pérol, David; Canada, Brice; Roitmann, Eva; Dufresne, Armelle; Bachelot, Thomas; Heudel, Pierre; Trédan, Olivier; Touillaud, Marina; Pialoux, Vincent

doi:10.2196/10487

Cited by 23 publications

(29 citation statements)

References 47 publications

(45 reference statements)

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“…Identifying patients suffering from sarcopenia is a first step to acknowledge the increased risk for chemotoxicity and subsequently improve and adapt supportive care of these patients. Modern tools like smartphones are already used in patients with metastatic breast cancer for implementing a personalized physical activity program (9). Use of Health Apps increases the physical activity of patients (31).…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia as Prognostic Factor in Lung Cancer Patients: A Systematic Review and Meta-analysis

et al. 2019

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Background/Aim: Sarcopenia describes the loss of skeletal muscle mass. While this condition is associated with a high mortality in cancer patients, its influence on survival is still underestimated. Patients and Methods: A systematic review for articles was performed using the PubMed database, Cochrane Library, Biomed Central, Science Direct and by manual search. We used data of overall survival in sarcopenic patients for assessing the death risk. We extracted hazard ratio estimates from univariate and multivariate Cox proportional hazards models for meta-analysis. Results: A total of 15 studies were eligible for meta-analysis including a total of 2,521 lung cancer patients. Univariate meta-analysis revealed a twofold increased death risk in sarcopenic patients; multivariate meta-analysis yielded a significant, threefold elevated risk of death. This higher mortality is independent of tumour stage. Conclusion: Muscle loss is an independent risk factor for increased death risk in lung cancer patients independent of cancer stage. This argues for implementing screening for sarcopenia into cancer care. Sarcopenia describes the age-related loss of muscle mass and strength starting during the fourth to fifth decade of life. It is defined as a muscle mass of at least two standard deviations below the mean muscle mass found in young healthy adults (1-3). While often reported in the elderly, loss of muscle mass does also manifest in patients suffering from a chronical disease like congestive heart failure, chronical obstructive pulmonary disease, chronical renal failure or cancer. Muscle loss has a relevant impact on survival, especially in the latter group. The prevalence of sarcopenia in cancer patients depends on cancer entity, which is why a prevalence of 16% is described in breast cancer patients, whereas 71% of lung cancer patients under palliative therapy suffer from sarcopenia (4-6). Muscle wasting is an unfavourable prognostic factor for cancer specific survival of rectum, liver, oesophagus, stomach or kidney cancer patients (1, 7). If muscle mass is maintained or increased, patients show a longer overall survival (5). Sarcopenia may be caused by several different factors; cancer, chemotherapy or locoregional impairment caused by surgery or radiation therapy, comorbidities, malnutrition or physical inactivity (8). Sarcopenia itself is also a risk factor for an increase in chemotoxicity and a decrease in therapy response (1). Physical activity prevents muscle wasting; a small pilot study showed that smartphones are a good tool to implement personalized physical activity programs and to increase physical activity of patients (9, 10). Sarcopenia is assessed by using Dual-energy X-ray absorptiometry scan (DEXA), bioelectrical impedance analysis (BIA) or computed tomography (2). Especially computed tomography is used routinely for investigations 4603 This article is freely accessible online.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia as Prognostic Factor in Lung Cancer Patients: A Systematic Review and Meta-analysis

et al. 2019

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“…The ABLE02 trial was based on the promising results of the ABLE single-arm trial, which highlighted the interest of patients with MBC in participating in PA interventions but also an improvement in physical fitness as well as maintenance of muscle mass, quality of life and fatigue despite the progress of the disease [20,42]. The ABLE02 trial is the first study to test the efficacy of a PA program based on connected devices (smartphone application and activity tracker) to improve HRQoL and reduce fatigue in women with MBC and to assess the effect of an intervention on other biological, psychological and functional parameters.…”

Section: Discussionmentioning

confidence: 99%

“…The ABLE pilot study showed the feasibility to use connected activity trackers to perform a 6 month-unsupervised PA program in 51 MBC patients. The results showed patients' motivation towards this program (94% acceptance rate), an improvement in physical performance as well as maintenance of PA levels, HRQoL and fatigue despite disease progression [20,42]. These promising results need to be confirmed in a large multicenter, randomized controlled study.…”

Section: Introductionmentioning

confidence: 90%

Design and methods of a national, multicenter, randomized and controlled trial to assess the efficacy of a physical activity program to improve health-related quality of life and reduce fatigue in women with metastatic breast cancer: ABLE02 trial

Delrieu¹,

Anota²,

Trédan³

et al. 2020

BMC Cancer

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Background: Patients with a metastatic breast cancer suffer from a deteriorated health-related quality of life and numerous symptoms such as pain, severe fatigue and a decrease of their physical fitness. As the feasibility of a physical activity program has been demonstrated in this population, ABLE02 aims to assess the efficacy of a 6 month-physical activity program using connected devices to improve health-related quality of life and to reduce fatigue in women with metastatic breast cancer. Methods: ABLE02 is a prospective, national, multicenter, randomized, controlled and open-label study. A total of 244 patients with a metastatic breast cancer, with at least one positive hormone receptor and a first-line chemotherapy planned, will be randomly assigned (1:1 ratio) to: (i) the intervention arm to receive physical activity recommendations, an activity tracker to wear 24 h a day during the whole intervention (6 months) with at least three weekly walking sessions and quizzes each week on physical activity and nutrition (ii) the control arm to receive physical activity recommendations only. Health-related quality of life will be assessed every 6 weeks and main assessments will be conducted at baseline, M3, M6, M12 and M18 to evaluate the clinical, physical, biological and psychological parameters and survival of participants. All questionnaires will be completed on a dedicated application.

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“…The proportion of participants achieving the physical activity recommendations (≥ 10.5 MET-hours/week) was not different between inclusion and the end of the study with 34 (69.4%) vs (34 (77.3%) (p = 0.26). This unsupervised physical activity program may encourage patients to maintain a long term physically active lifestyle 49 .…”

Section: Discussionmentioning

confidence: 99%

Analysis of the StoRM cohort reveals physical activity to be associated with survival in metastatic breast cancer

Delrieu

Jacquet

Ségura-Ferlay

et al. 2020

Sci Rep

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Benefits of physical activity are widely demonstrated for early stage cancers but few studies have focused on metastatic disease. the purpose of this study was to determine the impact of physical activity on survival in patients with metastatic breast cancer. We conducted a secondary analysis of the national, multicentric, non-randomized, prospective cohort SNPs to Risk of Metastasis (StoRM) study. The level of physical activity was self-reported at inclusion and divided into three categories of physical activity: light level, moderate level, and vigorous level. Overall, 833 patients (56.2%) completed the physical activity questionnaire at baseline on average physical activity during the previous year: 11.6% had a light level of physical activity, 69.0% achieved moderate levels of physical activity and 19.3% reported vigorous levels of physical activity. After adjustment for confounding, physical activity was not statistically significantly associated with overall survival in the whole population. Subgroup analysis identified that both vigorous and moderate physical activity were associated with statistically significantly improved overall survival compared to light physical activity level only in the HER2 positive subgroup (HR 0.23; 95% CI 0.07-0.70, p = 0.01 and HR 0.38; 95% CI 0.15-0.96, p = 0.04). Physical activity done during the previous year was associated with survival in HER2 positive metastatic breast cancer patients. These results suggest that overall survival in metastatic breast cancer patients could be improved through physical activity which

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A Personalized Physical Activity Program With Activity Trackers and a Mobile Phone App for Patients With Metastatic Breast Cancer: Protocol for a Single-Arm Feasibility Trial

Cited by 23 publications

References 47 publications

Sarcopenia as Prognostic Factor in Lung Cancer Patients: A Systematic Review and Meta-analysis

Sarcopenia as Prognostic Factor in Lung Cancer Patients: A Systematic Review and Meta-analysis

Design and methods of a national, multicenter, randomized and controlled trial to assess the efficacy of a physical activity program to improve health-related quality of life and reduce fatigue in women with metastatic breast cancer: ABLE02 trial

Analysis of the StoRM cohort reveals physical activity to be associated with survival in metastatic breast cancer

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