A Phase II Randomized Placebo-Controlled Study of Fisetin and Exercise to Prevent Frailty in Breast Cancer Survivors

Summary

This phase II trial tests how well fisetin and exercise works in preventing frailty in breast cancer survivors. Fisetin is a natural substance found in strawberries and other foods and is available as a nutritional supplement. Nutritional supplements may be useful in eliminating cells that have undergone a process called senescence. Senescence is when a cell ages and permanently stops dividing but does not die. Over time, large numbers of these cells build up in tissues throughout the body and can release harmful substances that cause inflammation and damage nearby healthy cells. Giving fisetin may eliminate senescent cells in patients with breast cancer undergoing physical activity.

Detailed description

PRIMARY OBJECTIVE: I. To determine the effect of fisetin and/or exercise on physical function, as assessed using the 6-minute walk distance (6MWD), in chemotherapy-treated postmenopausal breast cancer survivors. SECONDARY OBJECTIVES: I. To determine the effect of fisetin and/or exercise on heart rate and step count, as measured by wearable device. II. To determine the effect of fisetin on other measures of physical function beyond 6MWD (short physical performance battery \[SPPB\], grip strength, frailty phenotype, physical activity). III. To determine the effect of fisetin and/or exercise on fatigue (Borg Rating of Perceived Exertion \[RPE\]). IV. To determine the effect of fisetin and/or exercise on neuropathy (Quality of Life Questionnaire - Chemotherapy-Induced Peripheral Neuropathy 20 \[QLQ-CIPN20\]). V. To determine the effect of fisetin and/or exercise on cognition (Patient Reported Outcomes Measurement Information System \[PROMIS\] cognitive function short form). VI. To determine the effect of fisetin and/or exercise on health-related quality of life (Short Form \[SF\]-36). VII. To determine the effect of fisetin on local and distant recurrence free survival (RFS). VIII. To determine the effect of fisetin on breast cancer-specific survival and overall survival. IX. To evaluate the safety and tolerability (National Cancer Institute \[NCI\] Common Terminology Criteria for Adverse Events \[CTCAE\] version \[v\]5.0) of fisetin. X. To estimate rates of adherence to fisetin and/or exercise regimen. EXPLORATORY OBJECTIVES: I. To determine the effect of fisetin and/or exercise on p16 expression in peripheral CD3+ T-cells. II. To determine the effect of fisetin and/or exercise on circulating senescence-associated secretory phenotype (SASP) inflammatory factors in blood and urine. OUTLINE: Patients are randomized to 1 of 4 arms. ARM AB: Patients receive fisetin orally (PO) on days 1-3 of each cycle. Treatment repeats every 14 days for 8 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive individually tailored supervised exercise training consisting of 30-45 minutes of aerobic training and 20-30 minutes of resistance training three times a week over 16 weeks. Patients undergo collection of blood samples on study. ARM A: Patients receive fisetin PO on days 1-3 of each cycle. Treatment repeats every 14 days for 8 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive handout on the importance of physical activity during baseline. Patients undergo collection of blood samples on study. ARM B: Patients receive placebo PO on days 1-3 of each cycle. Treatment repeats every 14 days for 8 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive individually tailored supervised exercise training consisting of 30-45 minutes of aerobic training and 20-30 minutes of resistance training three times a week over 16 weeks. Patients undergo collection of blood samples on study. ARM C: Patients receive placebo PO on days 1-3 of each cycle. Treatment repeats every 14 days for 8 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive handout on the importance of physical activity during baseline. Patients undergo collection of blood samples on study. Following completion of study intervention, patients are followed up on days 120 and 180 and then annually for up to 3 years.

Arms & interventions

• ProcedureBiospecimen Collection

  Undergo collection of blood samples

• OtherEducational Intervention

  Receive handout on physical activity

• OtherExercise Intervention

  Receive individually tailored exercise intervention

• DrugFisetin

  Given PO

• OtherPhysical Performance Testing

  Ancillary studies

• DrugPlacebo Administration

  Given PO

• OtherQuality-of-Life Assessment

  Ancillary studies

• OtherQuestionnaire Administration

  Ancillary studies

Outcome measures

Eligibility criteria