KEY TAKEAWAYS
- Through this CHOiCE trial, the impact of physical EX reduced mortality and recurrence risk, managed cancer treatment side effects, and improved the QoL in pts with cancer.
- The primary objectives were safety (using the Common Terminology Criteria for AEs) and feasibility (recruitment rate, adherence, and withdrawals).
- In patients with cancer, a 3-month exercise arbitration was safe, feasible, and effective in better physical activity, lower body strength, and QoL.
Physical exercise (EX) has been shown to have several potential advantages for cancer patients, including reducing mortality, lowering recurrence risk, managing treatment side effects, and improving quality of life (QoL). This study explored the safety, feasibility, and preliminary efficacy of a 3-month exercise arbitration in cancer patients.
In this pilot, a two-center randomized controlled trial of patients at the early stages of various cancers was investigated. Those assigned to the 3-month EX arbitration engaged in bi-weekly aerobic and resistance training tailored to individual baseline conditions and preferences. Over weeks, aerobic training duration increased, while the resistance component involved body weight or elastic-band exercises in 2-3 sets of 8-12 repetitions. Moderate EX intensity was monitored using the 10-point Borg Rating of Perceived Exertion Scale. Patients in the control group received standard care. The study focused on safety, assessed through the Common Terminology Criteria for Adverse Events (AEs), and feasibility, appraised by recruitment rate, adherence, and withdrawals. Secondary endpoints encompassed functional capacity (Six Minutes Walking Test) and muscle strength (Handgrip and Leg Press Test). QoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire (EORTC-QLQ-C30). Descriptive statistics and repeated-measures analysis of variance gauged within- and between-group differences.
A total of 57 patients (56 years; 68% breast, 14% colorectal) were recruited at a 38% rate and randomized to the EX-intervention (n = 37) and controls (n = 20). Five patients dropped out: 3 in the EX-group (leukemia onset, psychiatric disorder, and gonarthrosis) and 2 in the controls (lack of interest). Adherence to EX sessions was high at 93%.
The safety profile of the exercise program was favorable, with only 3 minor adverse events. These events included worsening lymphedema (Grade 1) in two participants and elbow inflammation (Grade 1) in one participant. The EX-group, compared to controls, reported a significant increase in functional capacity (within-group, p < 0.01) and lower limb strength (within and between-group, p < 0.01). Concerning the quality of life (QoL), EX produced enhancements in social function (within group, p < 0.05), fatigue (within group, p < 0.05), nausea and vomiting (within group, p < 0.01), dyspnea (within-group, p < 0.05), insomnia (within-group, p < 0.05), and loss of appetite (within-group, p < 0.01).
A combined aerobic and resistance exercise program in patients with cancer was safe, feasible, and can improve physical parameters and quality of life.
Future studies with larger sample sizes and more extended follow-up periods are required to confirm these findings and determine the long-term effects of exercise on cancer outcomes.
Source: https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.e24045
Clinical Trial: https://www.clinicaltrials.gov/study/NCT04226508
Sara Pilotto, F. G. Giuliano Scrivano, Anita Borsati, Daniela Tregnago, Ilaria Trestini, Lorenzo Belluomini, Silvia Riva, Marco Sposito, Jessica Insolda, Mauro Valentini, Emilio Bria, Federico Schena, Michele Milella, Massimo Lanza, Alice Avancini. DOI 10.1200/JCO.2023.41.16_suppl.e24045. J Clin Oncol 41, 2023 (suppl 16; abstr e24045).
