Cancer Patients' Performance Status Assessed Using Cardiopulmonary Exercise Testing and Wearable Data Generation

Study Overview
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Brief Summary
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The primary objective of this study is to establish the feasibility and value of physical fitness assessment within patients receiving cytotoxic chemotherapy. If successful, this project will establish the groundwork for physical function assessment in larger cancer clinical trials to assist patient selection and evaluation of toxicity and/or response among trial participants.

Detailed Description
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Physical fitness, whether measured by performance capacity or daily activity, can predict risk of toxicity while helping to evaluate toxicity itself in the course of cancer chemotherapy. Cytotoxic chemotherapy causes premature aging and frailty in many cancer patients, so measuring and improving physical function may also limit late morbidity and mortality. Clinician-rated performance status (cPS; e.g., ECOG or Karnofsky PS) with or without concomitant organ function testing is the usual gold standard for risk prognostication and patient selection in most cancer settings, but cPS is subjective, unreliable, and relatively sensitive only for patients with significant functional compromise. Objective evaluations of physical function have the potential to augment or even replace cPS in the cancer treatment setting.

Official Title
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Assessing Performance Status in Cancer Patients Using Cardiopulmonary Exercise Testing and Wearable Data Generation: A Prospective Observational Study

Conditions
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Malignant Solid Tumor, Hematologic Malignancies

Intervention / Treatment
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* Device: Biometric Devices
* Other: Physical Performance Testing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients receiving cytotoxic chemotherapy with at least a 3 week cycle (either adjuvant/curative or palliative) Age ≥ 18, prioritizing patients ≥ 60 years At least 6 weeks out from surgical resection Presence of working email address Access to internet at home and either access to wireless internet or cellular data reception Ability to read and understand English Ability to understand and comply with study procedures Exclusion Criteria: Dementia, altered mental status, or psychiatric condition that would prohibit the understanding or rendering of informed consent Contraindication to CPET per standard American Thoracic Society (ATS) guidelines

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Adjuvant and Curative Chemotherapy<br>30 participants. Primarily older (60+ years in age) cancer patients receiving cytotoxic chemotherapy with adjuvant or curative intent. Will undergo both the Physical Performance Testing and Biometric Devices interventions. | Device: Biometric Devices<br>* Patients will wear two devices: HealthPatch Sensor and Phillips Actiwatch. Health data (e.g. average steps per day, resting heart rate) will be collected and monitored over the course of a cycle of cytotoxic chemotherapy.<br>Other: Physical Performance Testing<br>* Patients will complete a CPET and 6 minute walk test within one week of starting an upcoming chemotherapy cycle and they will undergo a second CPET upon completion of said chemotherapy cycle.<br>|
| Palliative Chemoteraphy<br>30 participants. Primarily older (60+ years in age) cancer patients receiving cytotoxic chemotherapy with palliative intent. Will undergo both the Physical Performance Testing and Biometric Devices interventions. | Device: Biometric Devices<br>* Patients will wear two devices: HealthPatch Sensor and Phillips Actiwatch. Health data (e.g. average steps per day, resting heart rate) will be collected and monitored over the course of a cycle of cytotoxic chemotherapy.<br>Other: Physical Performance Testing<br>* Patients will complete a CPET and 6 minute walk test within one week of starting an upcoming chemotherapy cycle and they will undergo a second CPET upon completion of said chemotherapy cycle.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients being approached that agree to participate in the study | Measure 1 for study feasibility | 12 months | 
| Proportion of patients who complete both baseline and follow up CPET tests without significant testing-related adverse events | Measure 2 for study feasibility | 12 months | 
| Proportion of patients who wear HealthPatch and have data captured successfully for at least 75% of the time | Measure 3 for study feasibility | 12 months | 
| Patients who wear Philips Actiwatch and have data captured successfully for at least 75% of the time | Measure 4 for study feasibility | 12 months | 
| Proportion of patients for whom all data is successfully recorded within the database | Measure 5 for study feasibility | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VO2max measured both pre- and post-chemotherapy | Measured via cycle egometry | 12 months | 
| 6 Minute Walk Distance (6MWD) |  | 12 months | 
| Patient-reported sympotomatic toxicity and quality of life | Measured using PROMIS, PRO-CTCAE, Godin Leisure Time Exercise questionnaires and Geriatric Assessment | 12 months | 
| Patient activity/steps per day | Measured using Philips Actiwatch | 12 months | 
| Heart rate | Continuous heart rate data, resting heart rate, and heart rate variability will be measured using HealthPatch | 12 months | 
| Clinician-rated performance status | Clinician-rated ECOG and Karnofsky Performance Status (KPS) | 12 months | 
| Incidence and number of falls | Measured by HealthPatch | 12 months | 
| Sleep duration | Measured by Philips Actiwatch | 12 months |