INTense ExeRcise for SurviVAL Among Men with Metastatic Prostate Cancer (INTERVAL - GAP4)
NCT ID: NCT02730338
Last Updated: 2024-11-27
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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ACTIVE_NOT_RECRUITING
NA
866 participants
INTERVENTIONAL
2016-01-31
2026-10-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Arm A: Supervised exercise group
Supervised high intensity aerobic and resistance exercise tapering to self management with psychosocial support
High intensity aerobic and resistance training
Psychosocial support
Arm B: Self directed exercise group
Self directed exercise and psychosocial support group
Psychosocial support
Interventions
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High intensity aerobic and resistance training
Psychosocial support
Eligibility Criteria
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Inclusion Criteria
* mCRPC patients defined as; adenocarcinoma of the prostate with systemic metastatic disease despite castrate levels of testosterone (\<50 ng/dL) due to orchiectomy or LHRH agonist.
o Patients must have one or more of the following to be considered mCRPC
* Metastatic Disease Progression: \>20% increase in the sum of diameters of measurable lesions from the time of maximal regression or appearance of one or more new lesions.
* Bone Scan Progression: Appearance of one or more new lesions on bone scan attributable to prostate cancer.
* PSA Progression: PSA ≥2 ng/ml that has risen serially on at least two occasions, each at least one week apart (PSA1 \< PSA2 \< PSA3).
* PSMA PET/CT scan progression: Appearance of one or more new lesions on PSMA PET/CT scan attributable to prostate cancer.
* At enrolment, mCRPC patients must fit into one of the following 5 categories:
1. Treatment naïve for mCRPC (have not yet started approved therapies for CRPC ie: Abiraterone/Enzalutamide/Apalutamide / or Docetaxel, Cabazitaxel or other approved first line chemotherapy; less than 4 weeks on approved therapies is still considered to be treatment naïve) Or
2. Receiving Abi/Enza/Apa for mCRPC AND responding or stable (PSA values must be stable or declining after at least 4 weeks since starting Abi/Enza/Apa for mCRPC) Or
3. Patients with PSA progression while on Abi/Enza/Apa are eligible as long as they are asymptomatic AND there is no intent on starting chemotherapy within 6 months Or
4. Patients treated with Docetaxel, Cabazitaxel or other approved first line chemotherapy as first line for mCRPC who are asymptomatic without ANY evidence of progression Or
5. Patients may have progressed following first line Docetaxel, Cabazitaxel or other first line chemotherapy and are now receiving treatment with Abi/Enza/Apa. These patients must absolutely be responding or stable (PSA values must be stable or declining after starting Abi/Enza/Apa treatment) and have an estimated life expectancy of more than 1 year.
mHSPC Status:
* mHSPC patients must be classified as either high-risk or high-volume mHSPC. These groups are defined as adenocarcinoma of the prostate with systemic metastatic disease and patients also fit into one of the following 2 categories: 6. High-risk: defined as having at least 2 of three criteria: (i) Gleason score ≥8, (ii) presence of ≥3 lesions on bone scan, or (iii) presence of INTERVAL Protocol Version 5.0, 19 August 2019 4 measurable visceral lesions (PSMA PET imaging should not be used in the definition of high-risk disease) Or 7. High-volume: defined as having the presence of visceral metastases and/or ≥ four bone metastases with at least one outside of the vertebral column and pelvis (PSMA PET imaging should not be used in the definition of high-volume disease)
Additional criteria for all groups:
* All patients will be required to be on ADT during the study period or have had a prior bilateral orchiectomy.
* Men with small cell neuroendocrine tumours or features of small cell disease are not eligible.
* ≥4 weeks since last major surgery and fully recovered.
* No known contraindications to high intensity exercise, including, but not limited to: brain metastases; current congestive heart failure (New York Heart Association Class II, III or IV); serious or non-healing wound, ulcer, or bone fracture; spinal cord compromise or instrumentation due to metastatic disease; peripheral neuropathy ≥grade 3. No serious cardiovascular events within 12 months including, but not limited to, transient ischemic attack (TIA), cerebrovascular accident (CVA), or myocardial infarction (MI). Patients with a history of hypertension must be well-controlled (\< 160/90) on anti-hypertensive therapy.
* Halabi Nomogram score \<1951 (Risk Category rated as low or intermediate risk)
* Age ≥18 years
* Required Baseline Laboratory Values: ANC ≥ 1500/uL; Platelet count ≥ 100,000/uL; Creatinine ≤ 1.5 x upper limits of normal; Bilirubin ≤ 1.5 x upper limits of normal; AST ≤ 1.5 x upper limits of normal; Serum testosterone ≤ 50 ng/dL
* ECOG performance status 0-1
* Medical clearance by treating physician to undergo a symptom-limited cardiopulmonary exercise test and vigorous aerobic and resistance exercise training, and able to complete an acceptable cardiopulmonary exercise test.
* Exercise Coordination Centre (ECC) review and approval of subject's screening bone scan / areas with bone metastases.
* Men participating in vigorous aerobic exercise for \>60 min/week or structured resistance exercise ≥2 days/week, are not eligible.
* Subject is willing and able to use technological aspects of the trial.
* The subject is fluent in the language as designated by the institution at which he would be enrolled.
18 Years
MALE
No
Sponsors
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University of California, San Francisco
OTHER
Edith Cowan University
OTHER
King's College London
OTHER
Centre hospitalier de l'Université de Montréal (CHUM)
OTHER
Movember Foundation
OTHER
Responsible Party
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Principal Investigators
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Robert Newton
Role: STUDY_CHAIR
Edith Cowan University
Fred Saad
Role: STUDY_CHAIR
Centre hospitalier de l'Université de Montréal (CHUM)
Locations
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Cedars Sinai Medical Centre
Los Angeles, California, United States
UCSF
San Francisco, California, United States
UC Denver
Denver, Colorado, United States
University of Minnesota
Minneapolis, Minnesota, United States
Oregon Health & Science University
Portland, Oregon, United States
Fred Hutchinson Cancer Centre
Seattle, Washington, United States
Australian Prostate Cncr Research Centre
Brisbane, Queensland, Australia
University of Queensland
Brisbane, Queensland, Australia
Victoria University / Sunshine Hospital
Melbourne, Victoria, Australia
Edith Cowan University
Perth, Western Australia, Australia
University of Alberta
Edmonton, Alberta, Canada
Centre Hospitalier de l'Université de Montréal (CRCHUM)
Montreal, , Canada
German Sport University Cologne
Cologne, , Germany
Erasmus MC
Rotterdam, , Netherlands
University of Surrey
Guildford, Surrey, United Kingdom
Queen's University Belfast
Belfast, , United Kingdom
University of Glasgow
Glasgow, , United Kingdom
Kings College London
London, , United Kingdom
Countries
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References
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Umlauff L, Kenfield SA, Newton RU, Hart NH, Saad F, Courneya KS, Greenwood R, Bloch W; INTERVAL-GAP4 Steering Committee/Coordinating Centres Members/Protocol Development Working Group Members; Schumann M. Meeting Aerobic Physical Activity Guidelines and Associations With Physical Fitness in Men With Metastatic Prostate Cancer: Baseline Results of the Multicentre INTERVAL-GAP4 Trial. Cancer Med. 2024 Dec;13(23):e70261. doi: 10.1002/cam4.70261.
Kim JS, Taaffe DR, Galvao DA, Clay TD, Redfern AD, Gray ES, Newton RU. Enhancing circulatory myokines and extracellular vesicle uptake with targeted exercise in patients with prostate cancer (the MYEX trial): a single-group crossover study. BMC Cancer. 2024 Jul 1;24(1):784. doi: 10.1186/s12885-024-12530-0.
Newton RU, Kenfield SA, Hart NH, Chan JM, Courneya KS, Catto J, Finn SP, Greenwood R, Hughes DC, Mucci L, Plymate SR, Praet SFE, Guinan EM, Van Blarigan EL, Casey O, Buzza M, Gledhill S, Zhang L, Galvao DA, Ryan CJ, Saad F. Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4): a multicentre, randomised, controlled phase III study protocol. BMJ Open. 2018 May 14;8(5):e022899. doi: 10.1136/bmjopen-2018-022899.
Other Identifiers
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GAP4
Identifier Type: -
Identifier Source: org_study_id
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