ISRCTN ISRCTN24557328
DOI https://doi.org/10.1186/ISRCTN24557328
IRAS number 315059
ClinicalTrials.gov number NCT06491784
Secondary identifying numbers CPMS 58172
Submission date
02/08/2024
Registration date
22/10/2024
Last edited
06/11/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Malignant pleural mesothelioma (MPM) is an aggressive cancer that is strongly associated with asbestos exposure. It most frequently affects the lining of the lung (pleura), but can also affect the other parts of the body, including the lining of the heart and abdomen. Patients with MPM often experience troublesome symptoms including breathlessness, pain and fatigue. They can also experience anxiety and depression and feel like their quality of life is worse than before they were diagnosed. Unfortunately, the average life expectancy following a diagnosis of mesothelioma is about 12 months. Currently, treatment in patients who are fit enough is aimed at prolonging this life expectancy and involves drug treatment in the form of either chemotherapy or more recently immunotherapy. Whether a person with mesothelioma receives this treatment can depend on their physical fitness. Improving health-related quality of life (HRQoL) and physical fitness is a key goal for all patients with MPM, and maximising treatment opportunities has never been more important following the recent approval of immunotherapy for the treatment of MPM across the UK. Exercise therapy is a rational approach to improving HRQoL and could also improve and/or maintain physical fitness to allow more patients to ultimately receive treatment. There is currently no evidence for the role of exercise therapy in mesothelioma. The aim of this study is to determine whether it is feasible to recruit and randomise patients with mesothelioma in a study of exercise therapy.

Who can participate?
Patients aged 18 years and over with mesothelioma

What does the study involve?
Once a participant consents to the study, they will undergo a baseline assessment, which will include the completion of an HRQoL questionnaire and a fitness assessment, which will include a 6-minute walk test (which measures the distance the participant can walk in 6 minutes), a hand grip strength measurement and counting how many times the participant can rise from a chair in 30 seconds (30-second sit to stand test). Once this baseline assessment has been completed, participants are randomly allocated to either intervention or standard of care. The intervention group involves the participant being assessed by a qualified physiotherapist or qualified exercise specialist with specialist cancer training before being provided with a 12-week personalised exercise and wellbeing programme, which includes exercise three times per week. Participants will be asked to complete HRQoL questionnaires at about 8, 16 and 26 weeks after enrolment; and functional fitness testing at 16 weeks after enrolment. The standard of care group involves routine clinical follow-up with completion of HRQoL questionnaires at about 8, 16 and 26 weeks after enrolment; and functional fitness testing at 16 weeks after enrolment.

What are the possible benefits and risks of participating?
It is possible that a personalised exercise programme could improve symptoms and quality of life in patients with mesothelioma. However, it is important to stress that this is not yet proven and will need testing in a larger study if the current study shows promising results.
Exercise in patients with mesothelioma is generally safe, however, exercise can be associated with complications such as joint pain, muscle soreness, injury and fatigue. Very uncommonly, exercise can be associated with heart attack or heart rhythm abnormality, but this is rare, even in people with a heart condition and extremely rare in people who do not have pre-existing heart conditions.

Where is the study run from?
The study is run from two UK mesothelioma centres: The Queen Elizabeth University Hospital in Glasgow and Wythenshawe Hospital in Manchester.

When is the study starting and how long is it expected to run for?
July 2023 to July 2025

Who is funding the study?
Mesothelioma UK

Who is the main contact?
Dr Selina Tsim, selina.tsim@glasgow.ac.uk

Contact information

Dr Selina Tsim
Public, Scientific, Principal Investigator

Queen Elizabeth University Hospital
1345 Govan Road
Glasgow
G51 4TF
United Kingdom

Phone +44 (0)141 451 6163
Email Selina.Tsim@glasgow.ac.uk

Study information

Study designMulti-centre non-blinded randomized feasibility study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeOther, Quality of life, Safety
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleEXercise TheRApy in Mesothelioma - The EXTRA-Meso feasibility study
Study acronymEXTRA-Meso
Study objectivesStudy hypothesis is that it is feasible to recruit patients with mesothelioma to a randomised study of exercise therapy versus standard care
Ethics approval(s)

Approved 02/10/2023, West Midlands - South Birmingham Research Ethics Committee (2 Redman Place, London, E20 1JQ, United Kingdom; +44 (0)207 104 8345; southbirmingham.rec@hra.nhs.uk), ref: 23/WM/0186

Health condition(s) or problem(s) studiedMesothelioma
InterventionOnce a participant consents to the study, they will undergo a baseline assessment, which will include the completion of an HRQoL questionnaire and a fitness assessment, which will include a 6-minute walk test (which measures the distance the participant can walk in 6 minutes), a hand grip strength measurement and counting how many times the participant can rise from a chair in 30 seconds (30-second sit to stand test). Once this baseline assessment has been completed, participants are randomly allocated to either intervention or standard of care. Randomisation is a 1:1 randomisation using random permuted blocks via a validated online system (sealedenvelope.com). The intervention group involves the participant being assessed by a qualified physiotherapist or qualified exercise specialist with specialist cancer training before being provided with a 12-week personalised exercise and wellbeing programme, which includes exercise three times per week. Participants will be asked to complete HRQoL questionnaires at about 8, 16 and 26 weeks after enrolment; and functional fitness testing at 16 weeks after enrolment. The standard of care group involves routine clinical follow-up with completion of HRQoL questionnaires at about 8, 16 and 26 weeks after enrolment; and functional fitness testing at 16 weeks after enrolment.
Intervention typeOther
Primary outcome measureTotal number of patients recruited over 12 months
Secondary outcome measures1. Proportion of screened patients who do not meet study eligibility over 12 months
2. Of the patients who fail screening, which eligibility criteria have they failed to meet, over the 12-month recruitment period
3. Study drop-out rate, described as the proportion of patients enrolled in the study who withdraw before the end of the study period
4. Reasons for study drop-out (free text) recorded over the duration of the study period (18 months)
5. Intervention adherence rate, described as the proportion of patients randomised to exercise therapy who complete the 12-week exercise programme
6. Adverse events recorded over the duration of the study period (18 months)
7. Health-related quality of life (HRQoL) questionnaire completion rate, described as the proportion of questionnaires completed by study participants over the duration of the study period (18 months)
Overall study start date01/07/2023
Completion date31/07/2025

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit100 Years
SexBoth
Target number of participants40
Key inclusion criteria1. Diagnosis of mesothelioma, ratified by a mesothelioma multi-disciplinary team (MDT)
2. Performance status 0 - 2
3. Clinical frailty score ≤5
4. Informed consent
Key exclusion criteria1. Performance status ≥3
2. Clinical frailty score ≥6
3. Unlikely to be able to participate in an exercise programme (clinician/physiotherapist judgement)
Date of first enrolment30/01/2024
Date of final enrolment31/01/2025

Locations

Countries of recruitment

  • England
  • Scotland
  • United Kingdom

Study participating centres

Queen Elizabeth University Hospital
1345 Govan Road
Glasgow
G51 4TF
United Kingdom
Wythenshawe Hospital
Southmoor Road
Wythenshawe
Manchester
M23 9LT
United Kingdom

Sponsor information

NHS Greater Glasgow and Clyde
Hospital/treatment centre

Research & Innovation
Dykebar Hospital
Ward 11
Grahamston Road
Paisley
Glasgow
PA2 7DE
Scotland
United Kingdom

Phone +44 (0)141 314 4001
Email Kirsty.Theron@ggc.scot.nhs.uk
Website http://www.nhsggc.org.uk/
ROR logo "ROR" https://ror.org/05kdz4d87

Funders

Funder type

Charity

Mesothelioma UK

No information available

Results and Publications

Intention to publish date31/01/2026
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a peer-reviewed journal.
IPD sharing planThe datasets generated during and/or analysed during the current study will be available upon request from Dr Selina Tsim (selina.tsim@glasgow.ac.uk).

Data (HRQOL summary, functional fitness data summary, intervention adherence and dropout rate) will become available at the completion of study follow-up and data cleaning (approximately 31/10/2025). Consent to do so will be sought from participants via the participant information sheet and study consent form. All data would be anonymised as per ethical approval.

Editorial Notes

06/11/2024: Internal review.
02/08/2024: Study's existence confirmed by West Midlands - South Birmingham Research Ethics Committee.