Muscle Aging Phenotypes in Childhood Cancer Survivors

NCT07531498 | Not Yet Recruiting

• 2 other identifiers: MUSCLEMAPU01CA301480
• Study Type: observational
• Target: 533
• Locations: 1 country
• Sites: 1

Brief Summary

Childhood cancer survivors experience premature declines in muscle mass, strength, and physical function that contribute to morbidity and early mortality. The biological mechanisms driving these impairments are heterogeneous and poorly understood. This observational study aims to characterize distinct muscle health endotypes in adult survivors of childhood cancer using advanced imaging, neuromuscular testing, and functional assessment. Survivors with reduced muscle health and community controls will undergo multimodal magnetic resonance imaging and spectroscopy, nerve conduction studies, surface electromyography, body composition assessment, and physical performance testing during a single study visit integrated into an ongoing cohort evaluation. Identifying mechanistic endotypes of impaired muscle health will support development of targeted interventions to preserve function and improve long-term outcomes in childhood cancer survivors. Primary Objective: \- Characterize reduced muscle health endotypes in childhood cancer survivors. Secondary Objective: \- Identify specific treatment and lifestyle related risk factors for each reduced muscle health endotype. Exploratory Objective: \- Host germline genetics will be associated with specific muscle endotypes.

Conditions

Muscle Weakness; Low Muscle Mass; Sarcopenia

Keywords

Childhood Cancer Survivors; Adult Survivors of Childhood Cancer; Neuromuscular Function; Muscle Health

Outcome Measures

Primary Outcomes (3)

• Nerve conduction velocity (NCV) at rest and Electromyography (EMG) during submaximal and maximal force generation

  Nerve conduction velocity (NCV) of sural sensory and tibial motor nerves will be performed using electromyography with standard landmarks for electrode placement. Compound Muscle Action Potential (CMAP) and Sensory Nerve Action Potential (SNAP) amplitudes are measured from negative to positive peak, and velocities calculated based on onset latency. NCV testing at rest and EMG during submaximal and maximal force generation will allow us to characterize the impact of the peripheral nervous system and the motor unit on muscle health.

  Baseline

• Creatinine recovery post exercise with magnetic resonance imaging (MRI)

  The plantar flexion motion is performed during the dynamic CrCEST MRI and 31P MRS acquisitions to provide a standardized in scanner exercise stimulus that perturbs skeletal muscle energy metabolism in the calf muscles. We will perform Cr-weighted CEST MRI to map calf muscle Cr recovery kinetics following plantar flexion exercise using an ergometer device. MATLAB scripts will be used for post-processing CEST data. 31P-MRS is performed with 1H/31P dual-tuned surface/volume coil. PCr is determined by fitting the signal intensity of PCr following plantar flexion exercise to a mono-exponential function. We will acquire a steady state 31P-MR spectra for phosphorylated metabolite quantification.

  Baseline

• Intramyocellular and extramyocellular fat fraction in muscle during magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS)

  Multiparametric MRI, 1H-MRS and Fat fraction MRI will be performed. 1H-MRS is a unique tool for studies of lipid metabolism because it is the only noninvasive method that separately quantifies Intramyocellular and extramyocellular lipids (IMCL and EMCL). Fat fraction is a metric for fat accumulation in healthy muscle tissue because of perturbed fatty acid oxidation. Dixon MRI sequence will be used to measure intramuscular fat fraction in legs and abdomen. MATLAB scripts are used for post- processing Dixon data. We will perform multiparametric quantitative MRI (PMID: 40172709). 1H-MRS is performed on a Siemens 3T scanner using Point RESolved Spectroscopy (PRESS) sequence (PMID: 3326459). A water-suppressed 1H spectrum will be acquired from a voxel positioned in gastrocnemius and soleus muscles. 1H- MRS data will be processed using LCModel (PMID: 8139448).

  Baseline

Study Arms (4)

Community Controls

Adults with no history of cancer recruited from the community or non-first-degree relatives of St. Jude patients.

Other: Multimodal Muscle Imaging and Functional Assessment

Survivors With Low Lean Mass or Weakness and Peripheral Neurotoxin Exposure

Adult childhood cancer survivors with low lean mass and/or muscle weakness and documented exposure to peripheral neurotoxic therapies.

Other: Multimodal Muscle Imaging and Neuromuscular Assessment

Survivors With Low Lean Mass or Weakness Without Peripheral Neurotoxin Exposure

Adult childhood cancer survivors with low lean mass and/or muscle weakness and no history of exposure to peripheral neurotoxic therapies.

Other: Comprehensive Muscle Phenotyping

Survivors With Low Lean Mass and Muscle Weakness (Regardless of Neurotoxin Exposure)

Adult childhood cancer survivors meeting criteria for both low lean mass and muscle weakness, irrespective of treatment exposure.

Other: Integrated Neuromuscular and Imaging Evaluation

Interventions

Multimodal Muscle Imaging and Neuromuscular Assessment OTHER

Participants complete advanced neuromuscular and imaging assessments, including MRI-based evaluation of muscle structure and fat infiltration; magnetic resonance spectroscopy to assess mitochondrial oxidative metabolism; DXA and BIA for lean mass measurement; nerve conduction studies; surface electromyography during submaximal and maximal muscle activation; and physical function testing, performed during a single study visit.

Survivors With Low Lean Mass or Weakness and Peripheral Neurotoxin Exposure

Integrated Neuromuscular and Imaging Evaluation OTHER

Participants receive integrated phenotyping of muscle health using multimodal MRI and MRS imaging, neuromuscular testing with EMG and nerve conduction velocity, body composition assessment, and standardized physical performance measures to identify muscle aging endotypes.

Survivors With Low Lean Mass and Muscle Weakness (Regardless of Neurotoxin Exposure)

Multimodal Muscle Imaging and Functional Assessment OTHER

Participants undergo comprehensive muscle phenotyping, including magnetic resonance imaging (MRI) to assess muscle cross-sectional area and fat fraction; magnetic resonance spectroscopy (¹H MRS and ³¹P MRS) to evaluate skeletal muscle mitochondrial energetics; body composition assessment using dual energy X ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA); nerve conduction velocity testing; surface electromyography (EMG); and standardized physical performance testing.

Community Controls

Comprehensive Muscle Phenotyping OTHER

Participants undergo protocol-defined observational assessments including MRI and MRS of skeletal muscle, body composition analysis via DXA and BIA, neuromuscular testing with nerve conduction velocity and surface electromyography, and functional performance evaluations to characterize muscle health and underlying biological mechanisms.

Survivors With Low Lean Mass or Weakness Without Peripheral Neurotoxin Exposure

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population includes adults aged 18 years or older enrolled in the St. Jude Lifetime Cohort (SJLIFE) who are childhood cancer survivors and community control participants without a cancer history. Eligible survivors are at least five years from primary cancer diagnosis and have reduced muscle mass and/or muscle strength based on age- and sex-specific z-scores. Survivors are categorized by prior exposure to peripheral neurotoxic cancer therapies. Community controls are frequency-matched by age and sex. All participants complete neuromuscular, imaging, and physical function assessments during a single study visit.

You may qualify if:

• Age 18 years old or older at time of consent and enrolled in SJLIFE.
• Participant (100 per group for a total of 400) is/has:
• Group 1: No cancer history
• Group 2: Age and sex specific relative lean mass z-score of less than -0.5 OR age and sex specific hand grip or isokinetic (60 degrees/sec) quadriceps strength z-score of \<-0.5 AND exposure to a peripheral neurotoxin.
• Group 3: Age and sex specific relative lean mass z-score of less than -0.5 OR age and sex specific hand grip or isokinetic (60 degrees/sec) quadriceps strength z-score of \<-0.5 AND NOT exposed to a peripheral neurotoxin.
• Group 4: Age and sex specific relative lean mass z-score of less than -0.5 AND age and sex specific hand grip strength or isokinetic (60 degrees/sec) quadriceps strength z-score of \<-0.5 REGARDLESS of exposure status.
• Participant or legal guardian is able and willing to give informed consent.

You may not qualify if:

• Presence of implanted medical devices or metal that would interfere with MRI or MRS.
• Female Participant is pregnant.
• Body weight exceeding 300 pounds, due to MRI restrictions.
• Inability to lie flat on his/her back for 90 minutes or longer for MRI.
• Inability or unwillingness of research participant or legal guardian/representative to give written informed consent.
• Presence of known radiation-induced nerve injury.
• Prescence of pre-existing neurologic (non-cancer related) or who develop chronic neurologic disorders (i.e. Charcot Marie Tooth Disease, Downs, congenital brain injury).
• Participation on a lifestyle or medication clinical trial within the past 1 year.

Sponsors & Collaborators

• St. Jude Children's Research Hospital: lead
• National Cancer Institute (NCI): collaborator

Study Sites (1)

St. Jude Children's Research Hospital

Memphis, Tennessee, 38105, United States

Location

Related Links

• St. Jude Children's Research Hospital
• Clinical Trials Open at St. Jude

Biospecimen

Retention: SAMPLES WITH DNA

Biospecimens previously collected and stored as part of the St. Jude Lifetime Cohort (SJLIFE), including blood-derived DNA, may be used for analyses in this study. No new biospecimens are collected or retained specifically for this protocol.

MeSH Terms

Conditions

Muscle Weakness; Sarcopenia

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Muscular Atrophy; Atrophy; Pathological Conditions, Anatomical

Study Officials

• Kirsten Ness, PhD

  St. Jude Children's Research Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Kirsten Ness, PhD

CONTACT

888-226-4343; referralinfo@stjude.org

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 27, 2026
• First Posted: April 15, 2026
• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): May 1, 2030
• Study Completion (Estimated): May 1, 2031
• Last Updated: July 28, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Data will be made available at the time of article publication.
• Access Criteria: Data will be provided to researchers following a formal request with the following information: full name of requestor, affiliation, data set requested, and timing of when data is needed. As an informational point, the lead statistician and study principal investigator will be informed that primary results datasets have been requested.

Locations

US (1)