The purpose of this study is to assess the feasibility of a prehab intervention among American Indian (AI) patients diagnosed with cancer and measure inflammatory biomarkers to evaluate the preliminary impact of the trial intervention. The central hypothesis is that this community-informed prehab intervention will demonstrate feasibility, patient acceptability, and modulation of host and tumor-microenvironment inflammatory biomarkers. Aim 1: Implement the prehab translational clinical trial for AI patients with cancer scheduled for treatment. Aim 2 Measure host and tumor-microenvironment (TME) biomarkers using paired serum and tissue samples to compare baseline and post-intervention levels of expression. Serum markers include CRP, IL-6, IL-10, TNFa, IGF-1, VEGF, complete blood count (CBC) with differential, comprehensive metabolic panel (CMP), and prealbumin. Tissue markers include Ki67, insulin receptor, TNFa, NFKB, NOS2, and cleaved caspase 3. Aim 3: (optional exploratory aim): Assess differential expression of inflammatory genes in the TME using tumor tissue samples to compare baseline and post-intervention levels of expression. This will be done with a panel that analyzes inflammatory genes only.
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Patient enrollment and retention: proportion of patients who initiate the intervention, provide pre-intervention measurements and return for post-intervention measurements
Timeframe: Baseline and post-intervention (an average of 5 weeks)
Adherence to study protocol: compliance with intervention foods (walnuts)
Timeframe: 3 weeks during participant's preoperative window
Adherence to study protocol: compliance with exercise recommendations
Timeframe: 3 weeks during participant's preoperative window
Assessing patient acceptability via exit interviews to solicit patient experience and feedback
Timeframe: 3 weeks during participant's post-intervention assessment
Comparison of pre/post-intervention 6 Minute Walk Test Scores to assess lifestyle behavioral change
Timeframe: Baseline and post-intervention assessment (an average of 3 weeks)
Comparison of pre/post-intervention sit-to-stand test scores to assess lifestyle behavioral change
Timeframe: Baseline and post-intervention assessment (an average of 3 weeks)
Comparison of pre/post-intervention patient responses to the Dietary Screener Questionnaire
Timeframe: Baseline and post-intervention assessment (an average of 3 weeks)
Comparison of pre/post-intervention patient responses to the Arizona Activity Questionnaire
Timeframe: Baseline and post-intervention assessment (an average of 3 weeks)
Assessing biosample collection rates: percentage of patients completing blood and tissue sample collection
Timeframe: Baseline and post-intervention assessment (an average of 3 weeks)