# Virtual reality support during systemic cancer therapy to improve anxiety/depressive symptoms and reduce toxicity in patients with gastrointestinal cancers—OncoVR

## TL;DR

This study explores whether using virtual reality during cancer treatment can reduce anxiety, depression, and treatment side effects in gastrointestinal cancer patients.

## Contribution

The study introduces a novel VR-based intervention to support cancer patients during systemic therapy and evaluates its feasibility and impact.

## Key findings

- VR support is hypothesized to reduce psychological stress and therapy-related toxicities in cancer patients.
- The trial will assess feasibility based on patient tolerance of VR use for at least 20 minutes.
- Patient-reported outcomes will be measured using validated psychological and toxicity scales.

## Abstract

Systemic cancer therapy may trigger anxiety/depressive symptoms and toxicity. Relaxation techniques can help alleviate toxicities but their implementation in clinical practice is challenging. We hypothesize that virtual reality (VR) systems which project a relaxing nature environment may help to reduce psychological stress and toxicities of cancer therapies. This trial aims to evaluate the feasibility of a supportive VR intervention in patients receiving cancer therapies in an outpatient setting.

OncoVR is a randomized, open-label, cross-over trial to investigate the feasibility and impact of VR support during cancer therapy to improve anxiety, depressive symptoms, and toxicity in patients with gastrointestinal cancers. In total, 54 participants will be assigned to receive systemic therapy with VR support, followed by a subsequent course without VR support (arm A). Patients in arm B will first receive therapy without VR support, followed by a subsequent course with VR support. Primary endpoints are the feasibility of VR support (80% of the patients can tolerate its use for a minimum duration of 20 min), and changes in anxiety/depressive symptoms using the Hospital Anxiety and Depression Scale (HADS-D) and Positive and Negative Affect Schedule (PANAS) questionnaires. Secondary endpoints include the incidence and severity of therapy-associated toxicities per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) and Patient-Reported Outcomes version of the CTCAE (PRO-CTCAE) grading, and patient experience using the Player Experience Inventory (PXI) questionnaire.

Study Design Chart Overview

Title: Study Design for VR Support During Systemic Chemotherapy

Chart Structure:

Specifications tableSubject areaMedicine and DentistryMore specific subject areaPsychological support in oncology.Name of your trial in progressOncoVR—virtual reality support during systemic cancer therapy to improve anxiety/depressive symptoms and reduce toxicity in patients with gastrointestinal cancers.Reagents/toolsMeta Quest 3 VR headsets (Meta Platforms, Inc.)Nature Treks VR (Greener Games Ltd).Trial designOncoVR is randomized, open-label, cross-over trial assessing the feasibility and the impact of VR on anxiety/depressive symptoms and toxicity during infusional cancer therapy. In total, 54 participants will be assigned to receive one course of systemic therapy with VR support followed by a subsequent course without VR support (arm A). Patients in arm B will first receive systemic therapy without VR support, followed by a subsequent course with VR support. Primary endpoints are the feasibility and symptom reduction, evaluated using validated questionnaires. Secondary endpoints will include the incidence and severity of therapy-associated toxicity and patient experience including emotional, physical, and psychological impressions.Trial registrationDRKS00035719EthicsThe study is conducted with the Declaration of Helsinki. Informed consent will be obtained from all participants before enrolment. The trial was approved by the Ethics Committee of the Medical Faculty of the University Duisburg-Essen (Project No. 23-11671-BO).Value of the Trial in Progress−Addresses the unmet need for improved psychological support during systemic cancer therapy.−Investigates the effectiveness of VR technology in reducing anxiety and improving quality of life for cancer patients.−Aims to provide insights that may help optimize supportive care protocols in oncology.

Specifications table

Addresses the unmet need for improved psychological support during systemic cancer therapy.

Investigates the effectiveness of VR technology in reducing anxiety and improving quality of life for cancer patients.

Aims to provide insights that may help optimize supportive care protocols in oncology.

•OncoVR addresses the unmet need for psychological support during cancer therapy.•OncoVR investigates the feasibility of VR in cancer patients.•OncoVR may help optimize supportive care protocols in oncology.

OncoVR addresses the unmet need for psychological support during cancer therapy.

OncoVR investigates the feasibility of VR in cancer patients.

OncoVR may help optimize supportive care protocols in oncology.