Promoting positive physical activity behaviours in children undergoing acute cancer treatment: feasibility of the CanMOVE intervention

Background: Supporting children and adolescents with cancer to be physically active can improve medium- and long-term health outcomes. Objective: To assess the feasibility of CanMOVE, a 10-week complex, theoretically-informed, behaviour change intervention to promote physical activity for children and adolescents undergoing acute cancer treatment. Methods: A feasibility study using a single-group, repeated measures, mixed methods design. Participants completed CanMOVE, which included provision of a Fitbit (child/adolescent and carer) and structured support from a physical therapist. Feasibility domains of demand, acceptability, implementation, practicality, limited efficacy, and integration were evaluated. Data sources included service level data, objective assessment of physical activity, physical function, and health-related quality of life; and qualitative data collected via semi-structured interviews with participants and focus groups with staff. Results: Twenty children/adolescents (median age 13yrs, interquartile-range 9–14) with a mix of cancer diagnoses, 20 parents, and 16 clinicians participated. There was high demand with 95% enrolment rate. CanMOVE was acceptable for participants. All feasibility thresholds set for implementation were met. Under practicality, there were no serious adverse events related to the intervention. Limited efficacy data indicated CanMOVE showed positive estimates of effect in influencing child/adolescent physical activity behaviour, physical function, and health-related quality of life. Positive impacts were also seen in parent and staff attitudes towards physical activity promotion. To improve integration into the clinical setting, it was suggested the duration and scope of CanMOVE could be expanded. Conclusion: CanMOVE was feasible to implement in a paediatric cancer setting. CanMOVE is appropriate to be tested in a large-scale trial

Evaluating the measurement properties and feasibility of physical activity and physical function assessments for children undergoing acute cancer treatment

Background: As physical function and physical activity are often compromised among children and adolescents undergoing acute cancer treatment, psychometrically robust and feasible assessment tools are needed. The aim of this study is to evaluate the construct validity, responsiveness and feasibility of one physical activity assessment tool (Fitbit Inspire); and six physical function assessment tools (Movement ABC-2, Timed Up and Go, 30-s Chair Stand, Timed Rise from the Floor, Timed Up and Down Stairs, 6-min Walk Test) for children undergoing acute cancer treatment. Methods: A prospectively-registered, mixed methods, single-group study evaluated measurement properties against a priori hypothesis using Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) framework. Feasibility was assessed quantitively (a priori thresholds), and qualitatively (semi-structured interviews, focus-groups). Results: Twenty children/adolescents (median age 13 ​± ​5 years, various cancer diagnoses), 20 parents and 16 clinicians participated. Fitbit was feasible to assess daily steps only, had evidence of construct validity, tendency to overestimate step count and adequate evidence of responsiveness (compared to Actigraph). The 30-s Chair stand, 6-min Walk Test and Timed Up and Go were feasible and showed evidence of construct validity and responsiveness. To maximise feasibility, consideration of timing and intent of assessment are crucial. Conclusion: Fitbit has limitations as a physical activity assessment tool. The 30-s Chair Stand, 6-min Walk Test and Timed Up and Go were feasible to use and showed favourable measurement properties to assess physical function.</p

Datasheet1_Physician-defined severe toxicities occurring during and after cancer treatment: Modified consensus definitions and clinical applicability in the evaluation of cancer treatment.docx

Overall survival after cancer is increasing for the majority of cancer types, but survivors can be burdened lifelong by treatment-related severe toxicities. Integration of long-term toxicities in treatment evaluation is not least important for children and young adults with cancers with high survival probability. We present modified consensus definitions of 21 previously published physician-defined Severe Toxicities (STs), each reflecting the most serious long-term treatment-related toxicities and representing an unacceptable price for cure. Applying the Severe Toxicity (ST) concept to real-world data required careful adjustments of the original consensus definitions, translating them into standardized endpoints for evaluating treatment-related outcomes to ensure that (1) the STs can be classified uniformly and prospectively across different cohorts, and (2) the ST definitions allow for valid statistical analyses. The current paper presents the resulting modified consensus definitions of the 21 STs proposed to be included in outcome reporting of cancer treatment.</p

Additional file 1 of Lessons learnt in the first year of an Australian pediatric cardio oncology clinic

Additional file 1. Supplementary data

Additional file 2 of Prospective longitudinal evaluation of treatment-related toxicity and health-related quality of life during the first year of treatment for pediatric acute lymphoblastic leukemia

Additional file 2: Data Table 1. HUI3 Data. Data Table 2. PedsQL Cancer Data. Data Table 3. Emotion Thermometer Data

Additional file 1 of Prospective longitudinal evaluation of treatment-related toxicity and health-related quality of life during the first year of treatment for pediatric acute lymphoblastic leukemia

Additional file 1: Supplementary Table 1. ASSET Health-Related Quality of Life Outcomes (PedsQL Cancer Module and HUI3). Supplementary Table 2. Parents’ emotional well-being (ET). Supplementary Table 3. COG vs. iBFM Protocol Group Health-Related Quality of Life Comparisons (HUI3, PedsQL & PedsQL Nausea, Pain & Procedural Anxiety subscales). Supplementary Table 4. COG vs. iBFM Protocol Group Health Related Quality of Life Comparisons (PedsQL Anxiety, Worry, Cognitive Functioning, Physical appearance & Communication subscales). Supplementary Table 5. COG vs. iBFM Protocol group parental emotional well-being comparisons (ET)

Integrating CardioOncology Across the Research Pipeline, Policy, and Practice in Australia—An Australian Cardiovascular Alliance Perspective

Over 18 million people worldwide were diagnosed with cancer in 2020, including over 150,000 people in Australia. Although improved early detection and treatment have increased the survival rates, cardiotoxic treatment and inadequate management of cardiovascular risk factors have resulted in cardiovascular disease (CVD) being one of the leading causes of non-cancer-related death and disability among cancer survivors. International guidelines outline the standards of care for CVD risk surveillance and management. However, Australian cardio-oncology policies and clinical guidelines are limited. There is increasing growth of cardio-oncology research in Australia and support from leading Australian professional bodies and advocacy and research networks, including the Cardiac Society of Australia and New Zealand, the Clinical Oncology Society of Australia, the National Heart Foundation of Australia, and the Australian Cardiovascular Alliance (ACvA). Thus, opportunities to drive multidisciplinary cardio-oncology initiatives are growing, including grant funding, position statements, and novel research to inform new policies. The ACvA has a unique flagship structure that spans the translational research pipeline from drug discovery to implementation science. This article aims to highlight how multidisciplinary cardio-oncology innovations could intersect with the seven ACvA flagships, and to showcase Australian achievements in cardio-oncology thus far. We summarise eight key priority areas for future cardio-oncology research that emerged. These strategies will strengthen cardio-oncology research and care in Australia, and drive new guidelines, policies, and government initiatives to ensure equity in health outcomes for all cardio-oncology patients