NCT02932332

Brief Summary

The goal of this clinical research study is to compare high-flow oxygen, low-flow oxygen, high-flow air, and low-flow air in helping to decrease shortness of breath in cancer patients. Researchers also want to learn if these therapies can help to improve lung function and quality of life.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
26

participants targeted

Target at P25-P50 for phase_2 cancer

Timeline
Completed

Started Oct 2016

Longer than P75 for phase_2 cancer

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 11, 2016

Completed
1 day until next milestone

First Submitted

Initial submission to the registry

October 12, 2016

Completed
1 day until next milestone

First Posted

Study publicly available on registry

October 13, 2016

Completed
4.9 years until next milestone

Results Posted

Study results publicly available

September 20, 2021

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 23, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 23, 2023

Completed
Last Updated

April 21, 2023

Status Verified

April 1, 2023

Enrollment Period

6.4 years

First QC Date

October 12, 2016

Results QC Date

July 20, 2021

Last Update Submit

April 20, 2023

Conditions

Keywords

shortness of breathoxygenbreathing therapies

Outcome Measures

Primary Outcomes (1)

  • Change in Dyspnea Numeric Score Between 0 and 10 Minutes

    We assessed dyspnea intensity 'now' using a numeric rating scale from 0 to 10 where 0=none and 10=worst. The minimal clinically important difference was 1 point.

    0 (baseline) minutes and at 10 minutes

Secondary Outcomes (2)

  • Change in Modified Borg Scale Intensity Between 0 and 10 Minutes

    0 (baseline) minutes and at 10 minutes

  • Change in Modified Borg Scale Unpleasantness Between 0 and 10 Minutes

    0 (baseline) minutes and at 10 minutes

Study Arms (4)

High-flow oxygen: Initial Therapy

ACTIVE COMPARATOR

4-Period crossover therapy where initial 10 minute breathing treatment with High-flow oxygen (HFOx) is followed by 3 different breathing therapies of Low-flow oxygen (LFOx), High-flow air (HFAir), and Low-flow air (LFAir) with 10 minute washout period before subsequent treatments for a total 80 minute study period accompanied by shortness of breath questionnaires.

Other: High-flow OxygenOther: Low-flow OxygenOther: High-flow AirOther: Low-flow Air

Low-flow oxygen: Initial Therapy

ACTIVE COMPARATOR

4-Period crossover therapy where initial 10 minute breathing treatment with Low-flow oxygen (LFOx) is followed by 3 different breathing therapies of HFOx, HFAir, and LFAir with 10 minute washout period before subsequent treatments for a total 80 minute study period accompanied by shortness of breath questionnaires.

Other: High-flow OxygenOther: Low-flow OxygenOther: High-flow AirOther: Low-flow Air

High-flow air: Initial Therapy

SHAM COMPARATOR

4-Period crossover therapy where initial 10 minute breathing treatment with High-flow oxygen (LFOx) is followed by 3 different breathing therapies of HFOx, LFOx, and LFAir with 10 minute washout period before subsequent treatments for a total 80 minute study period accompanied by shortness of breath questionnaires.

Other: High-flow OxygenOther: Low-flow OxygenOther: High-flow AirOther: Low-flow Air

Low-flow air: Initial Therapy

SHAM COMPARATOR

4-Period crossover therapy where initial 10 minute breathing treatment with Low-flow air (LFAir) is followed by 3 different breathing therapies of HFOx, LFOx, and HFAir with 10 minute washout period before subsequent treatments for a total 80 minute study period accompanied by shortness of breath questionnaires.

Other: High-flow OxygenOther: Low-flow OxygenOther: High-flow AirOther: Low-flow Air

Interventions

Optiflow Respiratory Humidifier used to deliver HFOx. Oxygen flow will be maximized (set between 20 and 60 L/min), if tolerated, to minimize dyspnea. FiO2 will be set at 100%.

Also known as: HFOx
High-flow air: Initial TherapyHigh-flow oxygen: Initial TherapyLow-flow air: Initial TherapyLow-flow oxygen: Initial Therapy

Low-flow Oxygen will be delivered by Optiflow in an identical manner to high flow, except provided at 2 L/min using a nasal cannula identical to that used for high-flow devices.

Also known as: LFOx
High-flow air: Initial TherapyHigh-flow oxygen: Initial TherapyLow-flow air: Initial TherapyLow-flow oxygen: Initial Therapy

Two level air flow (high and low) will be delivered by Optiflow in an identical manner to oxygen air flows, except that researchers will use pressurized air instead of oxygen. LFOx and LFAir will be provided at 2 L/min using a nasal cannula identical to that used for high-flow devices.

Also known as: HFAir
High-flow air: Initial TherapyHigh-flow oxygen: Initial TherapyLow-flow air: Initial TherapyLow-flow oxygen: Initial Therapy

Two level air flow (high and low) will be delivered by Optiflow in an identical manner to oxygen air flows, except that researchers will use pressurized air instead of oxygen. LFOx and LFAir will be provided at 2 L/min using a nasal cannula identical to that used for high-flow devices.

Also known as: LFAir
High-flow air: Initial TherapyHigh-flow oxygen: Initial TherapyLow-flow air: Initial TherapyLow-flow oxygen: Initial Therapy

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosis of cancer
  • Patients seen by palliative care, thoracic oncology, pulmonary medicine, or emergency care at MD Anderson Cancer Center
  • Dyspnea Numeric Rating Scale at rest \>/=3 of 10 (average over last 24 hour)
  • Non-hypoxemic (i.e. oxygen saturation \>90% on ambient air)
  • Able to communicate in English or Spanish
  • Age \>/= 18 years
  • Able to tolerate high-flow oxygen/air

You may not qualify if:

  • Memorial Delirium Rating Scale \>13
  • Hemodynamic instability
  • Respiratory failure requiring mechanical ventilation or non-invasive ventilation
  • Frequent use of rescue opioids \>8x/day or rescue bronchodilators \>8x/day over last 24 hours
  • Currently requiring high flow oxygen for oxygenation

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The University of Texas MD Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Publications (1)

  • Hui D, Hernandez F, Urbauer D, Thomas S, Lu Z, Elsayem A, Bruera E. High-Flow Oxygen and High-Flow Air for Dyspnea in Hospitalized Patients with Cancer: A Pilot Crossover Randomized Clinical Trial. Oncologist. 2021 May;26(5):e883-e892. doi: 10.1002/onco.13622. Epub 2020 Dec 15.

Related Links

MeSH Terms

Conditions

NeoplasmsDyspnea

Condition Hierarchy (Ancestors)

Respiration DisordersRespiratory Tract DiseasesSigns and Symptoms, RespiratorySigns and SymptomsPathological Conditions, Signs and Symptoms

Results Point of Contact

Title
David Hui, MD, Associate Professor/Palliative Care Med
Organization
UT MD Anderson Cancer Center

Study Officials

  • David Hui, MD

    M.D. Anderson Cancer Center

    STUDY CHAIR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
SUPPORTIVE CARE
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 12, 2016

First Posted

October 13, 2016

Study Start

October 11, 2016

Primary Completion

March 23, 2023

Study Completion

March 23, 2023

Last Updated

April 21, 2023

Results First Posted

September 20, 2021

Record last verified: 2023-04

Locations