ClinicalTrials.gov
ClinicalTrials.gov Menu

Food as Medicine: An RCT to Study the Effect of Home Delivered, Medically Tailored Meals on Patients With Metastatic Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT02887235
Recruitment Status : Recruiting
First Posted : September 2, 2016
Last Update Posted : September 29, 2017
Sponsor:
Information provided by (Responsible Party):
New York University School of Medicine

Brief Summary:
The purpose of this study is to determine whether medically tailored meals (HDTM) can improve quality of life for patients with metastatic cancer.

Condition or disease Intervention/treatment Phase
Quality of Life Other: Home Delivered, Medically Tailored Meals (HDTM) Not Applicable

Detailed Description:

The current standard of care at the cancer center is for all patients receiving cytotoxic therapy to undergo a nutritional consultation and evaluation with a registered oncology dietitian. The goal of this consultation is to prevent nutritional deficiencies, promote optimal nutritional intake, hydration, and weight maintenance, as well as maintain lean body mass.

All patients on this study will receive standard of care nutritional services including nutrition consult, evaluation, and as needed follow-ups. However, patients randomized to arm 2 will receive home delivered, medically tailored meals in addition to the standard nutritional care.


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 180 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Food as Medicine: A Phase III Randomized Controlled Trial of Home Delivered, Medically Tailored Meals (HDMTM) on Quality of Life in Metastatic Lung and Non-colorectal GI Cancer Patients
Study Start Date : March 2016
Estimated Primary Completion Date : March 2018
Estimated Study Completion Date : March 2019

Arm Intervention/treatment
No Intervention: Standard of Care (SOC) Meals
Patient assigned in this arm will receive standard of care nutritional services including nutrition consult, evaluation, and as needed follow-ups.
Active Comparator: Medically tailored meals
Patient assigned in this arm will receive home delivered, medically tailored meals (HDMTM) in addition to the standard nutritional care.
Other: Home Delivered, Medically Tailored Meals (HDTM)



Primary Outcome Measures :
  1. Quality of life measurement [ Time Frame: At 12 weeks follow up ]

    Quality of life will be assessed using the Functional Assessment in Cancer Therapy - General (FACT-G). Developed by Cella et al. the FACT-G is a well validated and widely used multi-dimensional health related quality of life measure for cancer patients. It consists of 28 self-assessment items on a 5 point Likert scale that address four domains:

    physical well-being, social/family well-being, emotional well-being, and functional well-being. Scores are calculated for each sub-scale per FACT scoring instructions and summed for a total score ranging between 0 and 108 with higher scores indicating a higher quality of life.



Secondary Outcome Measures :
  1. Change in mood assessment [ Time Frame: From baseline to 12 weeks ]
    The Hospital Anxiety Depression Survey will be utilized to assess patient mood on this study. It is a validated, 14 item self-assessment tool used to assess severity of anxiety and depression symptoms in patients. Two 7 item subscales assess anxiety and depression in the past one week. Item responses are integer values between 0-3 and values for each subscale are added to give a subscale score. Scores on each subscale can range from 0 to 21 and a score greater than 11 is considered consistent with anxiety or depression. Scores of 7 or less are considered normal and scores of 8 to 10 are borderline. A score of 8 or greater on the anxiety subscale has a sensitivity of 0.9 and specificity of 0.78 for anxiety. Similarly, a score of 8 or greater on the depression subscale has a sensitivity of 0.83 and specificity of 0.79 for depression.

  2. Patient weight assessment [ Time Frame: From baseline to 12 weeks ]
    Weight is measured at each physician visit per hospital policy. Weight at each interval will be recorded in the electronic medical record (EMR). Should the patient not have a scheduled visit with their primary oncologist or registered dietitian within the required visit window, any weight recorded in the EMR within the visit window can be used. The changes in weight from baseline to 12 weeks,will be measured using the Abridged Patient Generated Subjective Global Assessment (abPG-SGA) in the 2 arms.

  3. Nutritional status assessment [ Time Frame: From baseline to 12 weeks ]
    The change in nutritional status from baseline will be measured using the Abridged Patient Generated Subjective Global Assessment (abPG-SGA) in the 2 arms.

  4. Financial toxicity assessment [ Time Frame: From baseline to 12 weeks ]
    In 2014 a novel instrument to assess subjective financial toxicity, the Financial Toxicity Patient-Reported Outcome in Cancer measure (COST) was designed and recently validated. It is an 11 item assessment with 5 point Likert scale responses developed by de Souza et al reference to assess the levels of financial distress experienced by cancer patients. Each item response is scored 0-4 and then all individual item scores are summed. For incomplete surveys, the sum score is multiplied by 11 and then divided by the number of items answered. Total scores can range from 0-44 with higher scores representing higher subjective patient financial toxicity.

  5. Food security assessment plus HDMTM from baseline to 12 weeks [ Time Frame: From baseline to 12 weeks ]
    U.S. Adult Food Security Survey module to assess food security.It is a 10 item questionnaire developed by the US Department of Agriculture to specifically assess food insecurity in adults. Affirmative responses to each item are given one point. Total raw scores are calculated by adding all points (affirmative responses) and can range from 0-10. A raw score of zero is considered high food security. A raw score 1-2 is considered marginal food security. A raw score 3-5 is considered low food security and raw scores 6-10 are very low food security.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of pathologically confirmed metastatic pancreatic, hepatobiliary, esophageal, or lung cancer, either newly metastatic or metastatic at presentation (M1+) and enrollment within 6 weeks of diagnosis; measurable disease need not be present.
  • Pain Score (PS) 0-3
  • Age>18
  • Both male and female subjects eligible
  • All ethnicities eligible
  • Access to refrigerator or freezer

Exclusion Criteria:

  • Diagnosis of metastatic cancer no greater than 6 weeks prior to expected study enrollment
  • Currently receiving home delivered meals from other sources
  • Evidence of any alimentary tract obstruction or other condition preventing oral alimentation
  • Requirement for enteral or parenteral nutrition at time of diagnosis
  • Incarcerated individuals

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02887235


Contacts
Contact: Peter Schiff, MD, PhD Peter.Schiff@nyumc.org
Contact: Omar Ishaq, MD Omar.Ishaq@nyumc.org

Locations
United States, New York
NYU Perlmutter Cancer Center Recruiting
New York, New York, United States, 10016
Contact: Peter Schiff, MD, PhD       Peter.Schiff@nyumc.org   
Sponsors and Collaborators
New York University School of Medicine
Investigators
Principal Investigator: Peter Schiff, MD, PhD NYU Perlmutter Cancer Center
Principal Investigator: Omar Ishaq, MD NYU Perlmutter Cancer Center

Responsible Party: New York University School of Medicine
ClinicalTrials.gov Identifier: NCT02887235     History of Changes
Other Study ID Numbers: s15-00708
First Posted: September 2, 2016    Key Record Dates
Last Update Posted: September 29, 2017
Last Verified: September 2017

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No