An Interactive Time-Restricted Diet Intervention (txt4fasting) for Reducing Neurocognitive Decline and Improving Survival in Patients With Brain Metastases From Breast or Lung Cancer

Study Purpose

This clinical trial tests the effectiveness of an interactive time-restricted diet intervention (txt4fasting) in reducing neurocognitive decline and improving survival outcomes after stereotactic radiosurgery in patients with breast or lung cancer that has spread to the brain (brain metastases). Lung cancer and breast cancer are the two most frequent causes of brain metastases. The diagnosis of brain metastases is associated with poorer survival and tumor-induced and treatment-related side effects. Stereotactic radiosurgery is a type of external radiation therapy that uses special equipment to position the patient and precisely give a single large dose of radiation to a tumor. Patients who receive stereotactic radiosurgery for brain metastases may experience less neurocognitive side effects than with other types of brain radiation, but may still be at risk for their brain metastases growing, spreading, or getting worse. Patients with obesity and diabetes have been shown to have worse survival and increased radiation-related side effects. Evidence demonstrates that simply changing meal timing can have a positive impact on multiple health outcomes. Time-restricted eating, or prolonged nighttime fasting, has been proven to have positive effects on heart disease risk reduction, weight control management and chemotherapy side effect reduction. Txt4fasting may be effective in decreasing neurocognitive decline and improving survival outcomes in patients undergoing stereotactic radiosurgery for brain metastases from breast or lung cancer.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Age 18 years or older.
  • - Pathologically proven breast or lung cancer primary malignancy confirmed.
  • - Body mass index (BMI) ≥ 25 kg/m^2.
  • - SRS candidate (1-10 MRI detected brain metastases as per the discretion of radiologist) as determined by the treating physician.
  • - Chemotherapy, hormone, and immune therapy will be allowed concurrently.
  • - Willing and able to comply with the protocol for the duration of the study.
  • - Able to speak, read and write English.
  • - Negative pregnancy test if childbearing potential.
  • - Owns a mobile phone with mobile text messaging (TXT) capability.

Exclusion Criteria:

  • - Inability to tolerate a normal diet (may include an active malabsorption syndrome at the time of consent [i.e. Crohn's disease, major bowel resection leading to permanent malabsorption]) - Not a SRS candidate as determined by the treating physician.
  • - Prior brain surgery ≤ 14 days prior to enrollment.
  • - Intractable seizures while on adequate anticonvulsant therapy-more than 1 seizure per week for the past 2 months.
- Patient with a diagnosis of glioma, or other World Health Organization (WHO) grade II-IV primary brain tumor

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT06315296
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

N/A
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Thomas Jefferson University
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

N/A
Principal Investigator Affiliation N/A
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Anatomic Stage IV Breast Cancer AJCC v8, Metastatic Breast Carcinoma, Metastatic Lung Carcinoma, Metastatic Malignant Neoplasm in the Brain, Stage IV Lung Cancer AJCC v8
Additional Details

PRIMARY OBJECTIVE:

  • I. To examine the feasibility and acceptability of the txt4fasting intervention.
SECONDARY OBJECTIVES:
  • I. To compare neurocognitive function decline between the intervention and the control arms.
  • II. To compare progression free survival (PFS) between the intervention and the control arms.
TERTIARY (EXPLORATORY) OBJECTIVE:
  • I. To evaluate the change in biomarkers, from baseline to the end of the study, between the intervention and the control arms.
OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients follow a time-restricted diet, receive interactive positive reinforcement messages, and record food intake using the txt4fasting platform daily for 30 days. Patients receive counseling calls twice weekly in weeks 1 and 2 then once weekly in weeks 3 and 4. Patients then undergo stereostactic radiosurgery (SRS) on study. Patients also undergo blood sample collection and brain magnetic resonance imaging (MRI) throughout study. ARM II: Patients receive text messages about healthy eating habits and food suggestions twice daily and record food intake using txt4fasting program for 30 days. Patients then undergo SRS on study. Patients also undergo blood sample collection and brain MRI throughout study. After completion of study intervention, patients are followed up immediately at the end of the intervention, and at 3 and 6 months.

Arms & Interventions

Arms

Experimental: Arm I (txt4fasting)

Patients follow a time-restricted diet, receive interactive positive reinforcement messages, and record food intake using the txt4fasting platform daily for 30 days. Patients receive counseling calls twice weekly in weeks 1 and 2 then once weekly in weeks 3 and 4. Patients then undergo SRS on study. Patients also undergo blood sample collection and brain MRI throughout study.

Active Comparator: Arm II (attention control)

Patients receive text messages about healthy eating habits and food suggestions twice daily and record food intake using txt4fasting program for 30 days. Patients then undergo SRS on study. Patients also undergo blood sample collection and brain MRI throughout study.

Interventions

Behavioral: - Behavioral Dietary Intervention

Follow a time-restricted diet

Other: - Text Message-Based Navigation Intervention

Receive interactive positive reinforcement messages

Other: - Internet-Based Intervention

Use txt4fasting platform

Behavioral: - Dietary Counseling and Surveillance

Receive counseling calls

Radiation: - Stereotactic Radiosurgery

Undergo SRS

Procedure: - Biospecimen Collection

Undergo blood sample collection

Procedure: - Magnetic Resonance Imaging

Undergo brain MRI

Other: - Neurocognitive Assessment

Ancillary studies

Other: - Questionnaire Administration

Ancillary studies

Other: - Interview

Ancillary studies

Other: - Internet-Based Intervention

Use txt4fasting platform

Radiation: - Stereotactic Radiosurgery

Undergo SRS

Other: - Text Message-Based Navigation Intervention

Receive text messages about healthy eating habits and food suggestions

Procedure: - Biospecimen Collection

Undergo blood sample collection

Procedure: - Magnetic Resonance Imaging

Undergo brain MRI

Other: - Neurocognitive Assessment

Ancillary studies

Other: - Questionnaire Administration

Ancillary studies

Other: - Interview

Ancillary studies

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Philadelphia, Pennsylvania

Status

Recruiting

Address

Sidney Kimmel Cancer Center at Thomas Jefferson University

Philadelphia, Pennsylvania, 19107

Site Contact

Nicole Simone

[email protected]

215-955-6702

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