Connected Prehabilitation Program During Neo Adjuvant Chemotherapy

The main objective will be to determine if a prehabilitation program during NACT, for patients treated for an advanced ovarian cancer will limit physical alteration before major abdomino-pelvic surgery, compared to a control group without prehabilitation program. The primary endpoint will be the comparison of the variation of VO2 max, between baseline and surgery, in the prehabilitation group vs control group: VO2 max will be measured with a cardiopulmonary exercise test (CPET) at maximal effort.

This prospective, multicentric randomized control trial will be conducted in 7 French comprehensive cancer Centers or University Hospital, in compliance with inclusion criteria. After an initial evaluation, patients will be randomized in two groups: Prehabilitation group (P group) and a Control group (C group).

For the P group, after baseline evaluation, we will be offering from diagnosis to surgery, during the NACT:

• A standardized, patient-tailored preoperative physical activity training program will be performed at home, from diagnosis to surgery. Supervision will be done with connected device (connected watches) and activity will be adapted,
• A nutritional care established in respect of the SFNEP-SFNCM guidelines. Nutritional support will be adapted by a dietician according to information transmitted daily (connected body fat weight scale),
• A psychological support with coping strategies.

For the C group: Patients with ovarian cancer will undergo NACT after baseline evaluation without prehabilitation program.

After NACT, for both groups, major abdomino-pelvic surgery will be done with or without ERAS pathway, according to the practice in each center.

Inclusion criteria

• Patient must have signed the written consent,
• Age ≥ 18 years,
• Patient with advanced ovarian cancer (AOC), FIGO Stage III - IV, undergoing surgery,
• Patient with neo adjuvant chemotherapy (min 3 cycles, max 6 cycles),
• Capability to perform a cardiopulmonary exercise test (CPET)
• Patient affiliated to the national "Social Security" regimen or beneficiary of this regimen.

Exclusion criteria

• Patient with cognitive impairment,
• Pregnancy,
• Neoadjuvant treatment contraindications,
• Physical adapted activity program contraindication,
• No possibility to have access to connected devices or do not have a smartphone or a computer
• Patient deprived of liberty or placed under the authority of a tutor,
• Patient considered socially or psychologically unable to comply with the procedure and the required medical follow-up.