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RecruitingNCT06202183Updated Sep 11, 2026

Exercise for Gut Microbiome in Patients With Young-Onset Colorectal Cancer Undergoing Chemotherapy: The COURAGE Trial

An interventional study of Exercise Program in Colorectal Cancer, Metastatic Colon Cancer and Metastatic Colorectal Cancer, sponsored by Dana-Farber Cancer Institute. Recruiting at 1 site in United States. Open to participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-09-11.

Sponsored by Dana-Farber Cancer Institute · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
84
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
All
01

Study summary

This research study is a randomized controlled trial that will observe changes in microbiome activity, changes in chemotherapy toxicity, and any changes in treatment outcomes between two groups of participants undergoing chemotherapy with either early-stage or metastatic colorectal cancer.

The names of the study groups involved in this study are:

  • Exercise
  • Waitlist Control
Read the detailed description

This research study is a single-center, two-armed, randomized controlled trial that will observe changes in microbiome activity, changes in chemotherapy toxicity, and any changes in treatment outcomes between two groups of participants undergoing chemotherapy with either early-stage or metastatic colorectal cancer. Participants will be randomly assigned to one of two groups: Group A: Exercise group (EXE) vs. Group B: Waitlist control group (WC). Randomization means that a participant will be placed into one of the study groups by chance.

The research study procedures include screening for eligibility, blood tests, stool samples, and survey questionnaires.

Participation in this research study will last up to 6 months.

It is expected that about 84 people will take part in this research study.

The American Cancer Society is providing funding for this research study.

02

Conditions studied

  • Colorectal Cancer
  • Metastatic Colon Cancer
  • Metastatic Colorectal Cancer

Keywords

  • Colorectal Cancer
  • Metastatic Colon Cancer
  • Metastatic Colorectal Cancer
  • Early Stage Colorectal Cancer
03

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patient diagnosed with early-stage or metastatic colon or rectal cancer
  • Age at diagnosis 18-50 years; due to the specificity of the study question those outside the age bracket will not be included
  • No plans for major surgical intervention at the time of recruitment for a minimum of 12 weeks (i.e. study period; placement of port a cath is allowed)
  • No plans for radiation therapy at the time of recruitment for a minimum of 12 weeks
  • On or planning chemotherapy
  • Participate in less than or equal to 90 minutes of moderate-to-vigorous exercise per week
  • Medical clearance to perform exercise intervention and testing by their treating oncologist
  • No uncontrolled medical conditions that could be exacerbated with exercise
  • Ability to communicate and complete written forms in English
  • Ability to understand and the willingness to sign informed consent prior to any study-related procedures
  • Willing to travel to DFCI for necessary data collection

Exclusion criteria

Exclusion Criteria:

  • Participate in more than 90 minutes of moderate-to-vigorous aerobic exercise per week over the past month. This study targets insufficiently active persons to assess the effect of the described exercise intervention, where additional exercise done regularly will contaminate the intervention effects.
  • Unstable comorbidities that prevent participation in moderate-to-vigorous intensity exercise. Patients with unstable comorbidities may develop unexpected adverse events from exercise. For the purpose of patients' safety, as well as because this study involves remote, home-based exercise where close supervision is not possible, patients with unstable medical conditions are excluded.
  • Patients actively on a weigh loss diet and/or actively taking weight loss drugs. This could effect gut microbiome.
  • Patient with other active malignancies (excluding basal cell carcinoma).
  • Subjects who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study.
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
84 participants (estimated)

Study arms

  • Experimental
    Group A: Exercise Group

    42 participants will be enrolled using a permuted blocked design with varying block size and will complete study procedures as follows: * Baseline in-office visit. * Completion of exercise sessions 3x weekly. * Post-intervention in-office visit.

    Behavioral: Exercise Program

  • No intervention
    Group B: Waitlist Control Group

    42 participants will be enrolled using a permuted blocked design with varying block size and will complete study procedures as follows: * Baseline in-office visit. * Participants will be asked to maintain baseline exercise behavior and/or usual, daily activities. * Post-intervention in-office visit. Participants will be offered to participate in the exercise program upon the completion of post-intervention assessments.

Interventions

  • BehavioralExercise Program

    A 12 week, home-based, virtually supervised, aerobic and resistance exercise training program comprised of 36 sessions. Participants will be provided with a home stationary bike, resistance bands, and Fitbit. Virtually supervised sessions will be accessible via Zoom platform. For participants who do not have a device, a Wi-Fi-enabled tablet will also be provided.

05

What researchers measure

Primary outcomes

  1. Gut Microbiome Genomes

    Gut Microbiome Sequencing will be conducted using the stool samples at Baseline and Post-Intervention. Gut Microbiome sequencing will be performed using DNA and RNA extraction, which will analyze microbial genomes.

    Time frame: Baseline (Week 1) and Post-intervention (Week 13)

Secondary outcomes

  1. Change in Chemotherapy Toxicity

    To evaluate changes in chemotherapy toxicity following a exercise intervention in survivors of young-onset CRC undergoing chemotherapy.

    Time frame: 12 weeks

06

Study locations

1 of 1 sites recruiting
  • Dana Farber Cancer Institute
    Boston, Massachusetts 02215, United States
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: \[contact information for Sponsor Investigator or designee\]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.

Supporting information: Study protocol, Sap

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06202183
Lead sponsor
Dana-Farber Cancer Institute
Collaborators
American Cancer Society, Inc.
Responsible party
Christina Dieli-Conwright, PhD (Principal Investigator, Dana-Farber Cancer Institute) — Principal investigator
First posted
Jan 11, 2024
Start date
Jul 22, 2024
Primary completion
Jul 31, 2027 (estimated)
Completion
Jul 31, 2028 (estimated)
Last update
Sep 11, 2026

Study contacts

Christina Dieli-Conwright, MPH, PhD
Contact
ChristinaM_Dieli-Conwright@dfci.harvard.edu
617-582-8321
Christina Dieli-Conwright, MPH, PhD
principal investigator · Dana-Farber Cancer Institute

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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