Understanding how personalized nutrition and exercise programs can benefit cancer survivors

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Researchers with Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine have received funding to better understand how personalized nutrition and exercise programs can improve quality of life after cancer treatment.

The three-year, approximately $700,000 grant from the Applebaum Foundation with added support by Sylvester, will fund the On Precision Oncology Interventions in Nutrition and Training (OnPOINT) clinical study to develop individualized diet and activity programs for cancer survivors with complex needs.

"Initially, the study will focus on adults treated for breast, prostate and colorectal cancers," said multiple principal investigator Tracy E. Crane, PhD, RDN, co-lead of Cancer Control and director of lifestyle medicine, prevention and digital health at Sylvester. "Those are the three most common cancer types among U.S. survivors today."

According to the National Cancer Institute (NCI), breast, prostate and colorectal cancer patients represent more than half of all cancer survivors – about 9 million people nationwide.

Precision interventions

Sylvester researchers named the trial OnPOINT because of its focus on individualized plans. While all study patients will participate in an eight-week diet and exercise program, the interventions will differ for survivors based on their needs, said co-investigator Paola Rossi, MD, clinical program director of lifestyle medicine at Sylvester.

"The Oncology field is moving toward the delivery of precise interventions – getting the right intervention at the right time, for the right patient," she explained. "This study aims to do that with lifestyle strategies."

Researchers will use data from 300 study recruits to develop and refine an algorithm that will help guide decision-making about precision lifestyle support. At baseline, researchers will evaluate patients' physical fitness and diet using digital biometrics from wearable trackers, proven tests and self-reports of diet, exercise, sleeping habits and other activity. They'll also assess survivors' symptoms and quality of life to develop the interventions.

The algorithm will classify patients into one of three groups based on complexity, with varying intervention levels for each group.

For those whose needs fall into the high-complexity category, they will have one-on-one support with a dietitian and an exercise physiologist. Conversely, the low-complexity group may only need text-messaging support with a wearable device and journaling to keep on track."

Tracy E. Crane, PhD, RDN, co-lead of Cancer Control and director of lifestyle medicine, prevention and digital health at Sylvester

Researchers will reassess participants after eight weeks and again at six months.

"Our primary objective with this trial is to determine the feasibility of several approaches," she continued. "We're assessing wearable data and how it impacts clinical decision-making. "We're assessing the algorithm. And we're testing six different ways of delivering nutrition and exercise information."

Provider feedback

Another vital study component is learning what healthcare providers want to know about their patients and how involved they want to be with lifestyle modifications, Crane said. That's where Sylvester's proprietary My Wellness Research platform comes into play. It collects the data for researchers to transform into meaningful decision tools.

"We will create different visuals of patient-generated data in the electronic health record to obtain provider feedback on these presentations and what they think is most valuable to them," Crane explained.

She added that there are plans to expand OnPoint study recruitment to include blood-cancer survivors.

"We are excited to offer this study and additional support for Sylvester patients," Crane said. "It's a big undertaking with a big goal to better predict where to focus interventions and services to help survivors live healthy, quality lives after cancer treatment."

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