Modifying the CLARITY Trial: An Adaptation for a Holistic Cross-Training Algorithm in Patients with Various Cancer Diagnoses Undergoing Chemotherapy

Christopher Conquest, Rowan University
Joel West Ray MD, FACS, Rowan University

Poster Abstract

  • chemo brain, or chemotherapy induced cognitive impairment (CICI), affects memory, attention, executive functioning, and processing speed in cancer patients during and after treatment, significantly impacting their quality of life.1-4

  • It is caused by multiple interrelated mechanisms including direct neurotoxicity, blood-brain barrier disruption, neuroinflammation, oxidative stress, decreased neurogenesis, and white matter abnormalities- all of which contribute to cognitive decline.5

  • The CLARITY trial is the first randomized controlled study to examine how high-intensity interval training (HIIT) can improve cognitive function in breast cancer patients undergoing chemotherapy, using advanced tools like fMRI, DTI, and the NIH toolbox to assess brain changes alongside physical, metabolic, and psychosocial outcomes. 6

  • Expanding the CLARITY trial beyond breast cancer to include other cancer types acknowledges the shared burden of CICI across diagnosis, allowing for broader applicability and impact of exercise-based interventions.7

  • Incorporating a holistic cross-training model combining aerobic, strength, flexibility, nutritional modifications, and mindfulness training addresses individual variation in symptoms, treatment tolerance, and functional capacity, offering a more personalized and adaptable approach to improving cognitive and overall quality-of- life outcomes in cancer patients.

    • To develop and test a holistic cross training intervention tailored for diverse cancer patients undergoing chemotherapy, adapting key components of the CLARITY trail.

    • Key goals are to improve cognitive, physical, and psychosocial outcomes while creating a scalable, flexible algorithm that accounts for cancer type, fitness level, and treatment stage.

    • Evaluate the additive effects of a combined lifestyle intervention including nutritional modifications, mindfulness practices, weight control strategies, and tea consumption on cognitive outcomes.

    • We hypothesize that participants receiving the combined intervention will demonstrate greater improvements in executive function, memory, and emotional regulation, as measured by the Montreal Cognitive Assessment, NIH Toolbox, and brain imaging, compared with the baseline and the attention control group.

    • Assess the impact of integrated lifestyle interventions as previously stated on inflammation related biomarkers, oxidative stress, mood, fatigue, and quality of life.

    • We hypothesize that participants engaging in the multimodal approach will show greater reductions in systemic inflammation, improved body composition, enhanced psychological well-being, and lower subjective cognitive complaints compared with those in the HIIT-only and control group.

    • We are specifically revisiting the positively magnifying impact of the team-patient relationship in outcome maximization and cost containment.

This paper has been withdrawn.
 

Modifying the CLARITY Trial: An Adaptation for a Holistic Cross-Training Algorithm in Patients with Various Cancer Diagnoses Undergoing Chemotherapy

  • chemo brain, or chemotherapy induced cognitive impairment (CICI), affects memory, attention, executive functioning, and processing speed in cancer patients during and after treatment, significantly impacting their quality of life.1-4

  • It is caused by multiple interrelated mechanisms including direct neurotoxicity, blood-brain barrier disruption, neuroinflammation, oxidative stress, decreased neurogenesis, and white matter abnormalities- all of which contribute to cognitive decline.5

  • The CLARITY trial is the first randomized controlled study to examine how high-intensity interval training (HIIT) can improve cognitive function in breast cancer patients undergoing chemotherapy, using advanced tools like fMRI, DTI, and the NIH toolbox to assess brain changes alongside physical, metabolic, and psychosocial outcomes. 6

  • Expanding the CLARITY trial beyond breast cancer to include other cancer types acknowledges the shared burden of CICI across diagnosis, allowing for broader applicability and impact of exercise-based interventions.7

  • Incorporating a holistic cross-training model combining aerobic, strength, flexibility, nutritional modifications, and mindfulness training addresses individual variation in symptoms, treatment tolerance, and functional capacity, offering a more personalized and adaptable approach to improving cognitive and overall quality-of- life outcomes in cancer patients.

    • To develop and test a holistic cross training intervention tailored for diverse cancer patients undergoing chemotherapy, adapting key components of the CLARITY trail.

    • Key goals are to improve cognitive, physical, and psychosocial outcomes while creating a scalable, flexible algorithm that accounts for cancer type, fitness level, and treatment stage.

    • Evaluate the additive effects of a combined lifestyle intervention including nutritional modifications, mindfulness practices, weight control strategies, and tea consumption on cognitive outcomes.

    • We hypothesize that participants receiving the combined intervention will demonstrate greater improvements in executive function, memory, and emotional regulation, as measured by the Montreal Cognitive Assessment, NIH Toolbox, and brain imaging, compared with the baseline and the attention control group.

    • Assess the impact of integrated lifestyle interventions as previously stated on inflammation related biomarkers, oxidative stress, mood, fatigue, and quality of life.

    • We hypothesize that participants engaging in the multimodal approach will show greater reductions in systemic inflammation, improved body composition, enhanced psychological well-being, and lower subjective cognitive complaints compared with those in the HIIT-only and control group.

    • We are specifically revisiting the positively magnifying impact of the team-patient relationship in outcome maximization and cost containment.