Physical Exercise During Preoperative Chemotherapy for Breast Cancer

NCT ID: NCT05184582

Last Updated: 2025-09-22

Study Results

Results pending

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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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

712 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-09

Study Completion Date

2028-06-30

Brief Summary

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Neoadjuvant chemotherapy (NACT) is increasingly used in breast cancer. The best proof of NACT efficacy is pathological complete response (pCR), i.e. the absence of invasive tumour on post-NACT surgical histopathology. While it is known that physical exercise can help patients to better tolerate and complete often harsh cancer treatments, it is an emerging area of research to understand if and how exercise exerts anti-tumour effects and improves oncological outcomes.

The main aim of the Neo-ACT trial is to examine if a physical exercise intervention during NACT can increase pCR rates in breast cancer. Secondary aims are residual cancer burden, radiological tumour response, patient-related outcomes (health-related quality of life, physical activity), physiological outcomes (muscle strength, cardiorespiratory fitness), cancer treatment-related toxicities (cognitive dysfunction, chemotherapy completion rates) and long-term sick leave. Furthermore, the trial will explore how physical exercise affects anti-tumoral mechanisms inherent to therapy or host by hypothesis-generating translational analyses.

712 patients with primary invasive breast cancer will be randomized to either a supervised intervention of high-intensity interval and resistance training during NACT, supported by an exercise app, or to usual care, and followed for two years. Physical activity is meticulously tracked. By offering patients active involvement, the trial contributes strongly to the concept of personalized medicine.

Detailed Description

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The Neo-ACT assesses the primary endpoint pathological complete response (pCR) and the secondary endpoints Residual Cancer Burden (RCB), objective tumour response (RECIST), all-cause, breast cancer-specific, and recurrence-free survival at 2, 5 and 10 years, health-related quality of life assessed by the EORTC QLQ-C30 and BR23 questionnaires, self-reported physical activity (Modified Godin Leisure Time Physical activity questionnaire), toxicity-related outcomes (chemotherapy completion rates, number of unplanned hospital admissions during NACT, objective cognitive dysfunction (Amsterdam Cognition Scan), cardiac toxicity and sick leave), device-measured physical activity level (Fitbit activity tracker), muscle strength (handgrip strength test and hypothetical 1-RM maximal leg muscle strength tests), and cardiorespiratory fitness (Ekblom-Bak submaximal cycle test).

Participants randomized to the exercise group will complete 120 min exercise sessions per week from initiation of NACT to surgery (approx. five months):

* Progressive home exercise program by an individualised mobile phone application, supported by local physiotherapists
* Initial exercise intensity individually tailored to each patient's fitness at baseline and rate of perceived exertion during the program and adapted if required
* Sessions will begin with a 3-minute moderate intensity (12-13 on Borg's Rate of Perceived Exertion (RPE) scale) warm-up.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomization to supervised high-intensity interval training during neoadjuvant chemotherapy or usual information about physical activity.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard

Routine information on the benefit of physical activity

Group Type NO_INTERVENTION

No interventions assigned to this group

Intervention

High-intensity interval and strength training during neoadjuvant chemotherapy

Group Type EXPERIMENTAL

Physical training

Intervention Type BEHAVIORAL

Participants randomized to the exercise group will complete two structured 60-min exercise sessions per week from initiation of NACT to surgery (approx. five months).

Interventions

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Physical training

Participants randomized to the exercise group will complete two structured 60-min exercise sessions per week from initiation of NACT to surgery (approx. five months).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Patients with primary invasive breast cancer cT1-T3 cN0-2
* Full tumour biology available before initiation of NACT
* Oral and written consent
* Age ≥ 18 years

Exclusion Criteria

* Pregnancy or breast-feeding
* Bilateral invasive breast cancer
* The presence of musculoskeletal, neurological, respiratory, metabolic or cardiovascular conditions that may prevent safe completion of the exercise demands of the study
* Currently performing equal to or more than 150 mins of moderate to high intensity aerobic exercise and 2 sessions per week of moderate intensity resistance exercise
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Jana de Boniface

Ass. Prof, PI

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jana de Boniface

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Locations

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Cabrini Health

Melbourne, , Australia

Site Status NOT_YET_RECRUITING

Helsinki University Hospital

Helsinki, , Finland

Site Status RECRUITING

Turku University Hospital

Turku, , Finland

Site Status NOT_YET_RECRUITING

Karolinska University Hospital

Stockholm, Stockholm County, Sweden

Site Status RECRUITING

Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status RECRUITING

Skaraborgs sjukhus

Lidköping, , Sweden

Site Status RECRUITING

Capio St Görans Hospital

Stockholm, , Sweden

Site Status RECRUITING

Southern General Hospital

Stockholm, , Sweden

Site Status RECRUITING

Sundsvall Hospital

Sundsvall, , Sweden

Site Status RECRUITING

Umeå University Hospital

Umeå, , Sweden

Site Status RECRUITING

Västmanlands Hospital

Västerås, , Sweden

Site Status RECRUITING

Edinburgh Napier University

Edinburgh, Scotland, United Kingdom

Site Status NOT_YET_RECRUITING

Royal Marsden

London, , United Kingdom

Site Status NOT_YET_RECRUITING

Countries

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Australia Finland Sweden United Kingdom

Central Contacts

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Jana de Boniface

Role: CONTACT

+46702472305

Cecilia Haddad Ringborg

Role: CONTACT

Facility Contacts

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Eva Zopf

Role: primary

Peeter Karihtala

Role: primary

Eeva Juhanoja

Role: primary

Renske M Altena

Role: primary

Jenny Heiman

Role: primary

Per Nyman

Role: primary

Jana de Boniface

Role: primary

Sara Margolin

Role: primary

Anna-Karin Wennstig

Role: primary

Hanna Röjlar

Role: primary

Yvette Andersson

Role: primary

Frankie Brown

Role: primary

Marios Tasoulis

Role: primary

References

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de Boniface J, Altena R, Haddad Ringborg C, Bolam KA, Wengstrom Y. Physical exercise during neoadjuvant chemotherapy for breast cancer as a mean to increase pathological complete response rates: Trial protocol of the randomized Neo-ACT trial. PLoS One. 2022 Oct 13;17(10):e0274804. doi: 10.1371/journal.pone.0274804. eCollection 2022.

Reference Type DERIVED
PMID: 36227931 (View on PubMed)

Other Identifiers

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Neo-ACT

Identifier Type: -

Identifier Source: org_study_id

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