NCT06269536

Brief Summary

The aim of this interventional study is to test the heart-rate variability biofeedback intervention (HRV BI) in patients with muscle-infiltrating bladder carcinoma (MIBC) treated with chemotherapy based on cisplatin in neoadjuvant setting followed by local therapy (standard of care, SOC) compared to SOC alone.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
50

participants targeted

Target at P25-P50 for not_applicable

Timeline
34mo left

Started Feb 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress44%
Feb 2024Feb 2029

First Submitted

Initial submission to the registry

January 17, 2024

Completed
29 days until next milestone

Study Start

First participant enrolled

February 15, 2024

Completed
6 days until next milestone

First Posted

Study publicly available on registry

February 21, 2024

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 15, 2027

Expected
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

February 15, 2029

Last Updated

February 21, 2024

Status Verified

February 1, 2024

Enrollment Period

3 years

First QC Date

January 17, 2024

Last Update Submit

February 13, 2024

Conditions

Keywords

Muscle-Infiltrating Urothelial CarcinomaNeoadjuvant ChemotherapyStandard of CareHeart-Rate VariabilityBiofeedback InterventionInflammationQuality of LifeCognitive FunctionsSalivary Cortisol SlopesCircadian RhythmsSleep Quality

Outcome Measures

Primary Outcomes (7)

  • Primary Objective: Inflammation

    The effect of 3-month heart rate variability (HRV) biofeedback training and conventional cancer treatment (standard of care, SOC) vs. SOC alone on inflammation (IL-6, Tumor necrosis factor α, IL-10 in pg/ml).

    36 months

  • Primary Objective: Heart Rate Variability (HRV)

    The effect of 3-month heart rate variability (HRV) biofeedback training and conventional cancer treatment (standard of care, SOC) vs. SOC alone on HRV indexed by the root mean square of successive differences between heartbeats (RMSSD) in ms.

    36 months

  • Primary Objective: Quality of Life (QoL)

    The effect of 3-month heart rate variability (HRV) biofeedback training and conventional cancer treatment (standard of care, SOC) vs. SOC alone on EORTC-QLQ-C30 (version 3) score. The EORTC-QLQ-C30 has 30 items divided into five functional scales (physical, role, cognitive, emotional, and social), and three symptom scales (fatigue, pain, and nausea and vomiting). The score for each scale as well as the sum score for the whole instrument is standardized to values 0 to 100, with a higher score meaning a worse outcome.

    36 months

  • Primary Objective: Working memory

    The effect of 3-month heart rate variability (HRV) biofeedback training and conventional cancer treatment (standard of care, SOC) vs. SOC alone on working memory measured by digit span test score (the number of remembered digits in the longest passed sequence), for both forward and backward condition.

    36 months

  • Primary objective: Executive function

    The effect of 3-month heart rate variability (HRV) biofeedback training and conventional cancer treatment (standard of care, SOC) vs. SOC alone on executive function measured by Stroop task mean response time for color-word condition.

    36 months

  • Primary objective: Salivary Cortisol Slopes

    The effect of 3-month heart rate variability (HRV) biofeedback training and conventional cancer treatment (standard of care, SOC) vs. SOC alone on salivary cortisol slopes (difference between bedtime and awakening saliva cortisol concentration in ng/ml).

    36 months

  • Primary objective: Sleep Quality

    The effect of 3-month heart rate variability (HRV) biofeedback training and conventional cancer treatment (standard of care, SOC) vs. SOC alone on sleep quality measured by both actigraphy and self-report data. The main variables are total time spent sleeping (in hours and minutes), and sleep efficiency (proportion of time spent sleeping vs. time spent in bed trying to sleep).

    36 months

Secondary Outcomes (3)

  • Secondary objective: Serious Adverse Events

    36 months

  • Secondary objective: Disease-Free Survival (DFS)

    60 months

  • Secondary objective: Overall Survival (OS)

    60 months

Study Arms (2)

Heart-rate variability (HRV) biofeedback intervention + standard of care

EXPERIMENTAL

Deep paced breathing with the HRV monitoring performed three times a day for seven minutes during three months with standard of care.

Other: HRV biofeedback

Standard of care

NO INTERVENTION

Gemcitabine 1000 mg/m2 + Cisplatin 70 mg/m2 day 1 (new course day 22) or Methotrexate 30 mg/m2 day 1, Doxorubicin 30 mg/m2 day 2, Vinblastine 3 mg/m2 day 2, Cisplatin 70 mg/m2 day 2 with Pegfilgrastim 6 mg s.c. day 4 (new course day 15) up to 4 courses followed by radical cystectomy or irradiation with cisplatin 70 mg/m2 weekly.

Interventions

Daily deep paced breathing 3-times (minimum 7 minutes each) for 3 months

Also known as: physiologic
Heart-rate variability (HRV) biofeedback intervention + standard of care

Eligibility Criteria

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

You may qualify if:

  • Patients older than 18 years.
  • Evidence of muscle-infiltrating urothelial bladder carcinoma (including variants) by biopsy.
  • No prior chemotherapy.
  • No previous malignancy, except for basal-cell carcinoma of the skin within last 5 years.
  • Adequate renal functions: measured or calculated (by Cockcroft formula) creatinine clearance \> 60 ml/min.
  • Absolute granulocytes count 1,500/mm3 or higher, platelets 100,000/mm3 or higher, bilirubin 1.5x the upper limit of normal value and lower.
  • Adequate liver functions.
  • Basic computer skills.
  • Signed informed consent.

You may not qualify if:

  • Diabetes mellitus with symptomatic neuropathy.
  • Using antiarrhythmic drugs, opiates and/or antidepressants.
  • Implanted permanent pacemaker (PPM).
  • Human Immunodeficiency Virus (HIV) infection.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

National Cancer Institute

Bratislava, 83310, Slovakia

RECRUITING

MeSH Terms

Conditions

Urinary Bladder NeoplasmsInflammationSleep Initiation and Maintenance Disorders

Condition Hierarchy (Ancestors)

Urologic NeoplasmsUrogenital NeoplasmsNeoplasms by SiteNeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesUrinary Bladder DiseasesUrologic DiseasesMale Urogenital DiseasesPathologic ProcessesPathological Conditions, Signs and SymptomsSleep Disorders, IntrinsicDyssomniasSleep Wake DisordersNervous System DiseasesMental Disorders

Study Officials

  • Patrik Palacka

    Faculty of Medicine, Comenius University in Bratislava

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 17, 2024

First Posted

February 21, 2024

Study Start

February 15, 2024

Primary Completion (Estimated)

February 15, 2027

Study Completion (Estimated)

February 15, 2029

Last Updated

February 21, 2024

Record last verified: 2024-02

Data Sharing

IPD Sharing
Will share

Anonymised data of HRV, cognitive functions, quality of life, inflammatory markers, salivary cortisol, sleep quality, physical activity and psychological questionnaires.

Shared Documents
STUDY PROTOCOL, SAP, ANALYTIC CODE
Time Frame
Data will became available together with the publication and will be available for 5 years.
Access Criteria
Open.

Locations