Trial Outcomes & Findings for High-Flow Oxygen in Reducing Shortness of Breath Caused by Exercise in Patients With Cancer (NCT NCT02357134)

NCT ID: NCT02357134

Last Updated: 2022-12-07

Results Overview

Assessed Dyspnea using the Modified Borg Scale Dyspnea Intensity that ranges from 0 ("no shortness of breath") to 10 ("worst possible shortness of breath") at Isotime. Measured the mean difference of Modified Borg Scale Dyspnea Intensity at isotime between the second exercise test (in which all patients received Low Flow Oxygen) and the third exercise tests (in which all patients received the assigned intervention).

Recruitment status

UNKNOWN

Study phase

PHASE2

Target enrollment

74 participants

Primary outcome timeframe

End of second exercise test and end of third exercise test, approximately up to 12 minutes

Results posted on

2022-12-07

Participant Flow

Patients were recruited from the Supportive Care, Thoracic Radiation Oncology and Thoracic Medical Oncology clinics at MD Anderson Cancer Center, Houston, USA between 3/2015 and 4/2018 .

A total of 74 participants were enrolled but 45 patients were randomized for this study. 29 patients were not randomized for various reasons (became ineligible or too symptomatic to participate while waiting=14, scheduling conflict=9, exertional dyspnea too low=4, could not complete baseline test due to desaturation=1, hypertension during exercise=1)

Participant milestones

Participant milestones
Measure
High Flow Oxygen
High Flow Oxygen were delivered between 20 and 70 L/min.
High Flow Air
High Flow Air were delivered between 20 and 70 L/min.
Low Flow Oxygen
Low Flow Oxygen were delivered at 2 L/min.
Low Flow Air
Low Flow Air were delivered at 2 L/min
Overall Study
STARTED
11
11
12
11
Overall Study
COMPLETED
10
11
12
11
Overall Study
NOT COMPLETED
1
0
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
High Flow Oxygen
High Flow Oxygen were delivered between 20 and 70 L/min.
High Flow Air
High Flow Air were delivered between 20 and 70 L/min.
Low Flow Oxygen
Low Flow Oxygen were delivered at 2 L/min.
Low Flow Air
Low Flow Air were delivered at 2 L/min
Overall Study
Lost to Follow-up
1
0
0
0

Baseline Characteristics

High-Flow Oxygen in Reducing Shortness of Breath Caused by Exercise in Patients With Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
High Flow Oxygen
n=10 Participants
High Flow Oxygen were delivered between 20 and 70 L/min
High Flow Air
n=11 Participants
High Flow Air were delivered between 20 and 70 L/min
Low Flow Oxygen
n=12 Participants
Low Flow Oxygen were delivered at 2 L/min
Low Flow Air
n=11 Participants
Low Flow Air were delivered at 2 L/min
Total
n=44 Participants
Total of all reporting groups
Age, Continuous
59 years
n=93 Participants
67 years
n=4 Participants
63 years
n=27 Participants
62 years
n=483 Participants
63 years
n=36 Participants
Sex: Female, Male
Female
5 Participants
n=93 Participants
5 Participants
n=4 Participants
3 Participants
n=27 Participants
5 Participants
n=483 Participants
18 Participants
n=36 Participants
Sex: Female, Male
Male
5 Participants
n=93 Participants
6 Participants
n=4 Participants
9 Participants
n=27 Participants
6 Participants
n=483 Participants
26 Participants
n=36 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
2 Participants
n=483 Participants
4 Participants
n=36 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
10 Participants
n=93 Participants
10 Participants
n=4 Participants
11 Participants
n=27 Participants
9 Participants
n=483 Participants
40 Participants
n=36 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
0 Participants
n=36 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
0 Participants
n=36 Participants
Race (NIH/OMB)
Asian
1 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
1 Participants
n=36 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
0 Participants
n=36 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
1 Participants
n=483 Participants
5 Participants
n=36 Participants
Race (NIH/OMB)
White
7 Participants
n=93 Participants
10 Participants
n=4 Participants
11 Participants
n=27 Participants
10 Participants
n=483 Participants
38 Participants
n=36 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
0 Participants
n=36 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
0 Participants
n=36 Participants
Region of Enrollment
United States
10 participants
n=93 Participants
11 participants
n=4 Participants
12 participants
n=27 Participants
11 participants
n=483 Participants
44 participants
n=36 Participants
Cancer Type
Mesothelioma
0 Participants
n=93 Participants
0 Participants
n=4 Participants
2 Participants
n=27 Participants
3 Participants
n=483 Participants
5 Participants
n=36 Participants
Cancer Type
Non Small Cell Lung Cancer
7 Participants
n=93 Participants
9 Participants
n=4 Participants
7 Participants
n=27 Participants
5 Participants
n=483 Participants
28 Participants
n=36 Participants
Cancer Type
Small Cell Lung Cancer
1 Participants
n=93 Participants
1 Participants
n=4 Participants
2 Participants
n=27 Participants
2 Participants
n=483 Participants
6 Participants
n=36 Participants
Cancer Type
Other
2 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
1 Participants
n=483 Participants
5 Participants
n=36 Participants
Cancer Stage
Localized
1 Participants
n=93 Participants
3 Participants
n=4 Participants
3 Participants
n=27 Participants
0 Participants
n=483 Participants
7 Participants
n=36 Participants
Cancer Stage
Locally advanced
3 Participants
n=93 Participants
4 Participants
n=4 Participants
4 Participants
n=27 Participants
6 Participants
n=483 Participants
17 Participants
n=36 Participants
Cancer Stage
Metastatic
6 Participants
n=93 Participants
4 Participants
n=4 Participants
5 Participants
n=27 Participants
5 Participants
n=483 Participants
20 Participants
n=36 Participants
Comorbidities
COPD
5 Participants
n=93 Participants
3 Participants
n=4 Participants
2 Participants
n=27 Participants
1 Participants
n=483 Participants
11 Participants
n=36 Participants
Comorbidities
Heart Failure
1 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
0 Participants
n=483 Participants
3 Participants
n=36 Participants
Comorbidities
Asthma
1 Participants
n=93 Participants
1 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
2 Participants
n=36 Participants

PRIMARY outcome

Timeframe: End of second exercise test and end of third exercise test, approximately up to 12 minutes

Population: The data is provided for 44 participants who completed the study.

Assessed Dyspnea using the Modified Borg Scale Dyspnea Intensity that ranges from 0 ("no shortness of breath") to 10 ("worst possible shortness of breath") at Isotime. Measured the mean difference of Modified Borg Scale Dyspnea Intensity at isotime between the second exercise test (in which all patients received Low Flow Oxygen) and the third exercise tests (in which all patients received the assigned intervention).

Outcome measures

Outcome measures
Measure
High Flow Oxygen
n=10 Participants
High Flow Oxygen were delivered between 20 and 70 L/min
High Flow Air
n=11 Participants
High Flow Air were delivered between 20 and 70 L/min
Low Flow Oxygen
n=12 Participants
Low Flow Oxygen were delivered at 2 L/min
Low Flow Air
n=11 Participants
Low Flow Air were delivered at 2 L/min
Modified Borg Scale Dyspnea Intensity at Isotime
-1.1 score on a scale
Interval -2.1 to -0.12
-0.2 score on a scale
Interval -0.97 to 0.6
-1.8 score on a scale
Interval -2.7 to -0.9
-0.5 score on a scale
Interval -1.3 to 0.4

SECONDARY outcome

Timeframe: Third exercise test, approximately up to 12 minutes

Population: The data is provided for 44 participants who completed the study.

Dyspnea unpleasantness was measured using the Modified Borg Scale Dyspnea Intensity that ranges from 0 ("no shortness of breath") to 10 ("worst possible shortness of breath"). Dyspnea intensity was measured every minute. The number of minutes varied by patient, per test. It was measured as pairwise difference of slope (taking 'low flow air' arm as a reference). This linear mixed model was constructed based on the following: Dyspnea Unpleasantness at third test = Minutes + Study Arm + Study Arm\*Minutes + Total work rate + Slope of Dyspnea Unpleasantness and Minutes at Second test + Minutes at second test.

Outcome measures

Outcome measures
Measure
High Flow Oxygen
n=10 Participants
High Flow Oxygen were delivered between 20 and 70 L/min
High Flow Air
n=11 Participants
High Flow Air were delivered between 20 and 70 L/min
Low Flow Oxygen
n=12 Participants
Low Flow Oxygen were delivered at 2 L/min
Low Flow Air
n=11 Participants
Low Flow Air were delivered at 2 L/min
Slope of Modified Borg Scale Dyspnea Unpleasantness Over Time During Constant Work Exercise Per Minute (Third Test)
0.55 Units on a scale per minute
Interval 0.5 to 0.62
0.78 Units on a scale per minute
Interval 0.71 to 0.87
0.59 Units on a scale per minute
Interval 0.52 to 0.67
0.69 Units on a scale per minute
Interval 0.6 to 0.79

SECONDARY outcome

Timeframe: Third exercise test, approximately up to 12 minutes

Leg discomfort was measured using the Modified Borg Scale Leg discomfort that ranges from 0 ("no discomfort") to 10 ("worst possible discomfort") during the constant work exercise of third test. Leg discomfort was measured every minute. The number of minutes varied by patient, per test. It was measured as pairwise difference of slope (taking 'low flow air' arm as a reference). This linear mixed model was constructed based on the following: Leg Discomfort at third test = Minutes + Study Arm + Study Arm\*Minutes + Total work rate + Slope of Leg Discomfort and Minutes at Second test + Minutes at Second test.

Outcome measures

Outcome measures
Measure
High Flow Oxygen
n=10 Participants
High Flow Oxygen were delivered between 20 and 70 L/min
High Flow Air
n=11 Participants
High Flow Air were delivered between 20 and 70 L/min
Low Flow Oxygen
n=12 Participants
Low Flow Oxygen were delivered at 2 L/min
Low Flow Air
n=11 Participants
Low Flow Air were delivered at 2 L/min
Modified Borg Scale Leg Discomfort
0.59 Units on a scale per minute
Interval 0.53 to 0.64
0.91 Units on a scale per minute
Interval 0.82 to 0.99
0.65 Units on a scale per minute
Interval 0.58 to 0.74
0.81 Units on a scale per minute
Interval 0.71 to 0.91

SECONDARY outcome

Timeframe: End of third exercise test, approximately up to 12 minutes

The Exercise endurance was measured as a mean duration of constant work in minutes during third test. It was measured as pairwise comparison of mean difference of exercise duration (taking 'low flow air' as a reference). This linear mixed model was constructed based on the following: Time at third test = Study Arm + Minutes at Second test. Detail output from the mixed models

Outcome measures

Outcome measures
Measure
High Flow Oxygen
n=10 Participants
High Flow Oxygen were delivered between 20 and 70 L/min
High Flow Air
n=11 Participants
High Flow Air were delivered between 20 and 70 L/min
Low Flow Oxygen
n=12 Participants
Low Flow Oxygen were delivered at 2 L/min
Low Flow Air
n=11 Participants
Low Flow Air were delivered at 2 L/min
Exercise Endurance
10.50 minutes
Interval 7.48 to 13.52
8.18 minutes
Interval 7.03 to 9.34
7.58 minutes
Interval 6.0 to 9.17
7.36 minutes
Interval 6.35 to 8.37

SECONDARY outcome

Timeframe: Before and after 3rd test during intervention phase, approximately up to 12 minutes

Adverse effects related to supplemental oxygen use were assessed using a numeric rating scale from 0 (not at all) to 10 (worst possible) before and after the study intervention. The mean change was measured before and after the 3rd test ranging between -10 (improvement) and +10 (deterioration).

Outcome measures

Outcome measures
Measure
High Flow Oxygen
n=10 Participants
High Flow Oxygen were delivered between 20 and 70 L/min
High Flow Air
n=11 Participants
High Flow Air were delivered between 20 and 70 L/min
Low Flow Oxygen
n=12 Participants
Low Flow Oxygen were delivered at 2 L/min
Low Flow Air
n=11 Participants
Low Flow Air were delivered at 2 L/min
Adverse Events
Dry eyes
0 units on a scale
Standard Deviation 0
0 units on a scale
Standard Deviation 0
0.17 units on a scale
Standard Deviation 0.94
0 units on a scale
Standard Deviation 0
Adverse Events
Dry Nose
0 units on a scale
Standard Deviation 0
-0.45 units on a scale
Standard Deviation 1.21
-.033 units on a scale
Standard Deviation 0.89
0.3 units on a scale
Standard Deviation 0.67
Adverse Events
Eye Irritation
-0.1 units on a scale
Standard Deviation 0.32
0 units on a scale
Standard Deviation 0
0.33 units on a scale
Standard Deviation 1.15
0 units on a scale
Standard Deviation 0
Adverse Events
Moisture in nose
1 units on a scale
Standard Deviation 3.8
0.73 units on a scale
Standard Deviation 1.56
0 units on a scale
Standard Deviation 1.13
1.5 units on a scale
Standard Deviation 2.8
Adverse Events
Nasal Prongs Uncomfortable
-0.3 units on a scale
Standard Deviation 0.67
0.18 units on a scale
Standard Deviation 0.87
-0.17 units on a scale
Standard Deviation 0.94
0.3 units on a scale
Standard Deviation 0.67
Adverse Events
Suffocating
0.1 units on a scale
Standard Deviation 1.2
-0.09 units on a scale
Standard Deviation 0.54
0.08 units on a scale
Standard Deviation 0.29
0.4 units on a scale
Standard Deviation 0.7
Adverse Events
Anxious
0.4 units on a scale
Standard Deviation 1.78
-0.55 units on a scale
Standard Deviation 1.29
0.17 units on a scale
Standard Deviation 0.72
0.5 units on a scale
Standard Deviation 1.58
Adverse Events
Difficulty talking
-0.1 units on a scale
Standard Deviation 0.57
0.09 units on a scale
Standard Deviation 0.3
0 units on a scale
Standard Deviation 0
0 units on a scale
Standard Deviation 0

Adverse Events

High Flow Oxygen

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

High Flow Air

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Low Flow Oxygen

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Low Flow Air

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

David Hui, MD/ Associate Professor, Palliative Care Medicine

UT MD Anderson Cancer Center

Phone: (713) 792-6258

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place