Digital and AI-assisted multimodal supportive care, combining physical activity, nutrition, and pain management during chemotherapy for advanced pancreatic cancer patients: study protocol of the European multicenter randomized controlled trial of the RELEVIUM project

BMC Cancer

BMC Cancer

Research Authors: Barlo Hillen, Gabrielle Oestreicher, Lisa Schwab , Kira Enders , Perikles Simon, Anneli Elme, Irit Ben-Aharon, Tal Goshenlago, Cindy Neuzillet, Francesco Sclafani , Eva Ester Molina Beltran, Michael Schuster, Hristina Doncheva, Christian Ruckes, Michael Karlecik, Katja Petrowski, David Rosenbaum, Christos Diou, Aristotelis Ballas, Aggeliki Vlachostergiou, Davide Mastricci, Alexander Scherrer, Maximilian Pilz, Jonas Flechsig, Lazaros Apostolidis, Anna-Maria Krooupa, Sai Chintha, Isa Wasswa Musisi, Nefeli Panagiota Tzavara, Athanasios Kakasis, Xenia Hadjikypri, Styliani Karra, Kyriaki Chatzipanagiotou, Ioannis Drivas, Hugo Dacasa and Markus Moehler

Research Authors: Barlo Hillen, Gabrielle Oestreicher, Lisa Schwab , Kira Enders , Perikles Simon, Anneli Elme, Irit Ben-Aharon, Tal Goshenlago, Cindy Neuzillet, Francesco Sclafani , Eva Ester Molina Beltran, Michael Schuster, Hristina Doncheva, Christian Ruckes, Michael Karlecik, Katja Petrowski, David Rosenbaum, Christos Diou, Aristotelis Ballas, Aggeliki Vlachostergiou, Davide Mastricci, Alexander Scherrer, Maximilian Pilz, Jonas Flechsig, Lazaros Apostolidis, Anna-Maria Krooupa, Sai Chintha, Isa Wasswa Musisi, Nefeli Panagiota Tzavara, Athanasios Kakasis, Xenia Hadjikypri, Styliani Karra, Kyriaki Chatzipanagiotou, Ioannis Drivas, Hugo Dacasa and Markus Moehler

AIIM Authors: Owen Cha, Ethan Lowder

AIIM Authors: Owen Cha, Ethan Lowder

Publication Date: Oct 18, 2025

Publication Date: Oct 18, 2025

Comprehensive Summary

Hillen et al. analyzed whether artificial intelligence supported remote multimodal interventions, such as exercise, pain management, and nutrition, can improve the standards and quality of life for patients with severe, complex forms of pancreatic cancer. The research shows that pancreatic ductal adenocarcinoma (PDAC) is one of the more common forms of this cancer accounting for 90% of total cases. There are limited treatment options, and only a small proportion of the population is eligible for a surgery; the survival rate is around 10% (5 year survival rate), which emphasizes the need for more supportive measures. Malnutrition, cachexia, and sarcopenia (loss of muscle mass and function) are common symptoms, so the researchers wanted to focus on the physical rehabilitation aspect of recovery for these symptoms. Hillen et al. designed a study to test the functionality of an artificial intelligence trainer via RELEVIUM-RCT, splitting participants into a control group and an intervention group; the control group would not have any digital guidance in terms of their body metric assessment, while the intervention group would wear a smartwatch and use a mobile app. This technology specifically provided a numeric rating scale from 0-10 to assess pain daily with the information clinically accessible to the researchers as participants went about their daily lives. Automated alerts would trigger specifically when the pain scale would reach 5 or greater or if the patients heart rate variability (HRV) became abnormal. The mobile app provided educational training videos, pain management literacy, and guidance with medications. The research study is a study protocol, indicating that the researchers have not yet received results from their data yet, however the effectiveness of the RELEVIUM-RCT is still being thoroughly investigated through the research of Hillen et al.

Outcomes and Implications

While the results of the study protocol were not yet published, RELEVIUM-RCT poses great potential in the field of medicine and healthcare for patients with pancreatic cancer. If RELEVIUM-RCT proves to be effective, then the adoption of multimodal digital monitoring systems like telemedicine, mobile apps, and smartwatches as part of treatment is feasible; there would be more consistent symptom tracking with the technology as opposed to waiting for the patient’s next in person visit. The specificity of the tracking is especially helpful for clinicians and healthcare professionals as tracking the metrics such as HRV, physical activity, and nutrition can predict worsening symptoms prior to a potential emergency. Additionally, the online tracking and monitoring can be helpful for patients who may be burdened in terms of transportation. Tracking of symptoms online can be more cost and time efficient for many patients, and can be a safe and effective method to ensure proper health even away from a clinic or a healthcare setting. A possible limitation is the cost of such technology, as this may not be accessible to the entire population.

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