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| Name | Class |
|---|---|
| University of Tennessee Medical Center | OTHER |
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This study evaluates how lifestyle modifications that may be made to manage chemotherapy side effects in patients with gynecologic malignancies.
Since chemotherapy remains one of the primary treatment modalities for gynecologic malignancies, there is increasing interest in non-pharmacological methods of reducing chemotherapy side effects in cancer patients. Our goal is to increase the knowledge surrounding lifestyle modifications, specifically the fasting mimicking diet, on chemotherapy-related side effects, which may be more acceptable to patients than a previously studied water-only fasting diet. To expand this knowledge, The investigators will focus on patients undergoing chemotherapy for gynecologic malignancies. These patients will be assigned to no dietary restriction (control group) or a 5-day fasting mimicking diet (FMD by L-Nutra) for three days prior to, the day of, and one day following chemotherapy treatments (treatment group). The investigators aim to evaluate the feasibility of a fasting mimicking diet in addition to its metabolic effects on the body, patient reported side effects, patient quality of life, deviations or delays in treatment plans, and hospital admissions. Our hypothesis is that a fasting mimicking diet will significantly decrease chemotherapy-related side effects while providing good quality of life.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FMD | Experimental | In addition to the standard care, subject will consume a 5-day fasting mimicking diet. |
|
| Control | Active Comparator | Subjects will receive the standard care and no dietary changes. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fasting Mimicking Diet | Other | Subject will consume 6 cycles of 5-day fasting mimicking diet: 3 days prior to, the day of, and 1 day following chemotherapy treatments. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Quality of life by National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy Ovarian Cancer Symptom Index (NFOSI-18) questionnaire | The NFOSI-18 questionnaire allows for a uniform assessment of health-related quality of life through an 18-question (5-point Likert-type scale) survey including four subscale domains: Disease-Related Symptoms - Physical, Disease-Related Symptoms - Emotional, Treatment Side Effects. and Function/Well-Being. To calculate subscale scores, sum the item scores within each domain. Higher subscale scores indicate more significant symptom burden or impact. The total score is obtained by summing all 18 item scores. A higher total score reflects more severe symptoms overall. | Week 0-21 |
| Rate of Adherence | The ability to adhere to a 5-day fasting mimicking diet. | Week 0-21 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Body Weight | Change in body weight. | Week 0, Week12, Week 21 |
| Change in Body Composition | Changes in weight, skeletal muscle mass, body fat percentage by the Inbody(R) Body Composition Analyzer. |
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Inclusion Criteria:
Exclusion Criteria:
The study focuses on the chemotherapy of gynecologic malignancies.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Min Wei, PhD | Contact | 323.791.2426 | mwei@l-nutra.com | |
| Jonathan D Boone, MD | Contact | 8653055622 | jboone@utmck.edu |
| Name | Affiliation | Role |
|---|---|---|
| Jonathan D Boone | The University of Tennessee Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Tennessee Medical Center | Recruiting | Knoxville | Tennessee | 37920 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32669709 | Background | Caffa I, Spagnolo V, Vernieri C, Valdemarin F, Becherini P, Wei M, Brandhorst S, Zucal C, Driehuis E, Ferrando L, Piacente F, Tagliafico A, Cilli M, Mastracci L, Vellone VG, Piazza S, Cremonini AL, Gradaschi R, Mantero C, Passalacqua M, Ballestrero A, Zoppoli G, Cea M, Arrighi A, Odetti P, Monacelli F, Salvadori G, Cortellino S, Clevers H, De Braud F, Sukkar SG, Provenzani A, Longo VD, Nencioni A. Fasting-mimicking diet and hormone therapy induce breast cancer regression. Nature. 2020 Jul;583(7817):620-624. doi: 10.1038/s41586-020-2502-7. Epub 2020 Jul 15. | |
| 32576828 |
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| ID | Term |
|---|---|
| D010051 | Ovarian Neoplasms |
| D000093763 | Intermittent Fasting |
| ID | Term |
|---|---|
| D004701 | Endocrine Gland Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D010049 | Ovarian Diseases |
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| ID | Term |
|---|---|
| D004358 | Drug Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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Outcomes Assessor
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| Chemotherapy | Drug | 6 cycles of standard chemotherapy for the gynecologic malignancy. |
|
| Week 0, Week12, Week 21 |
| Change in HbA1c | Change in blood HbA1c. | Week 0, Week 21 |
| Change in Insulin Like Growth Factor 1 (IGF-1) Concentration | Change in blood insulin like growth factor 1 level. | Week 0, Week 21 |
| Change in Fasting Insulin Concentration | Change in fasting insulin level. | Week 0, Week 21 |
| Change in Fasting Glucose Concentration | Change in fasting glucose level. | Week 0, Week 21 |
| Change in High-sensitivity C reactive protein Concentration | Change in blood C reactive protein level. | Week 0, Week 21 |
| Change in Leptin Concentration | Change in blood leptin level. | Week 0, Week 21 |
| Change in planned chemotherapy regimen | Deviation from the planned chemotherapy regimen. | Week 0-21 |
| Number of Hospitalization Days | Days of hospitalization | Week 0-21 |
| Rate of Chemotherapy Side Effects | Rate of Adverse effects associated with chemotherapy | Week 0-21 |
| Background |
| de Groot S, Lugtenberg RT, Cohen D, Welters MJP, Ehsan I, Vreeswijk MPG, Smit VTHBM, de Graaf H, Heijns JB, Portielje JEA, van de Wouw AJ, Imholz ALT, Kessels LW, Vrijaldenhoven S, Baars A, Kranenbarg EM, Carpentier MD, Putter H, van der Hoeven JJM, Nortier JWR, Longo VD, Pijl H, Kroep JR; Dutch Breast Cancer Research Group (BOOG). Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial. Nat Commun. 2020 Jun 23;11(1):3083. doi: 10.1038/s41467-020-16138-3. |
| 29458369 | Background | Finnell JS, Saul BC, Goldhamer AC, Myers TR. Is fasting safe? A chart review of adverse events during medically supervised, water-only fasting. BMC Complement Altern Med. 2018 Feb 20;18(1):67. doi: 10.1186/s12906-018-2136-6. |
| 32694797 | Background | Goncalves MD, Cantley LC. A 'fast'er way to treat breast cancer. Nat Metab. 2020 Jul;2(7):559-560. doi: 10.1038/s42255-020-0225-6. No abstract available. |
| 22323820 | Background | Lee C, Raffaghello L, Brandhorst S, Safdie FM, Bianchi G, Martin-Montalvo A, Pistoia V, Wei M, Hwang S, Merlino A, Emionite L, de Cabo R, Longo VD. Fasting cycles retard growth of tumors and sensitize a range of cancer cell types to chemotherapy. Sci Transl Med. 2012 Mar 7;4(124):124ra27. doi: 10.1126/scitranslmed.3003293. Epub 2012 Feb 8. |
| 21088487 | Background | Raffaghello L, Safdie F, Bianchi G, Dorff T, Fontana L, Longo VD. Fasting and differential chemotherapy protection in patients. Cell Cycle. 2010 Nov 15;9(22):4474-6. doi: 10.4161/cc.9.22.13954. Epub 2010 Nov 15. |
| 20157582 | Background | Safdie FM, Dorff T, Quinn D, Fontana L, Wei M, Lee C, Cohen P, Longo VD. Fasting and cancer treatment in humans: A case series report. Aging (Albany NY). 2009 Dec 31;1(12):988-1007. doi: 10.18632/aging.100114. |
| 29174565 | Background | Moss HA, Havrilesky LJ. The use of patient-reported outcome tools in Gynecologic Oncology research, clinical practice, and value-based care. Gynecol Oncol. 2018 Jan;148(1):12-18. doi: 10.1016/j.ygyno.2017.11.011. Epub 2017 Nov 23. |
| D000291 |
| Adnexal Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D000091662 | Genital Diseases |
| D004700 | Endocrine System Diseases |
| D006058 | Gonadal Disorders |
| D005215 | Fasting |
| D005247 | Feeding Behavior |
| D001519 | Behavior |