Development of exercise as interception therapy for cancer: A review Journal Article

Authors: Iyengar, N. M.; Jones, L. W.
Article Title: Development of exercise as interception therapy for cancer: A review
Abstract: Importance: Observational data linking physical activity and exercise exposure with reduced risk of either development or progression of cancer have fueled interest in the initiation of large-scale definitive trials to test the association of exercise therapy with disease outcomes. However, several major knowledge gaps impede the rational and optimal design of such trials. Observations: Critical requirements underpinning the success of several recent contemporary anticancer agents have included adequate demonstration of antitumor activity (in phase 1/2 trials) as well as identification of essential prerequisites (eg, biologically effective dose and predictors of response) permitting optimal design of definitive trials. The existing evidence base investigating exercise as a candidate anticancer preventive or treatment strategy is predominantly confined to observational data, which have several inherent limitations. Consequently, the antitumor activity of exercise remains unclear and, perhaps more important, such data are not sufficient to accurately derive the exercise dose, prescription regimen, or patients most likely to benefit from exercise. In adherence with translational frameworks for lifestyle therapy development, the need for early phase 1/2-equivalent trials to fill current knowledge gaps to optimize the development and potential efficacy of exercise therapy is highlighted. Conclusions and Relevance: Exercise therapy has significant promise to be an efficacious and cost-effective therapy to improve cancer outcomes, with few toxic effects. Although most nontraditional therapies in cancer prevention and prognosis fail in definitive trials, these failures provide critical lessons for the continued development of exercise as a candidate anticancer therapy. © 2019 American Medical Association. All rights reserved.
Keywords: treatment response; review; cancer growth; nonhuman; antineoplastic agent; evidence based medicine; accuracy; disease association; cancer prevention; exercise; antineoplastic activity; cancer therapy; carcinogenesis; cost effectiveness analysis; prescription; patient compliance; clinical effectiveness; physical activity; lifestyle modification; risk reduction; study design; phase 2 clinical trial (topic); phase 1 clinical trial (topic); cancer prognosis; human; malignant neoplasm; interception therapy
Journal Title: JAMA Oncology
Volume: 5
Issue: 11
ISSN: 2374-2437
Publisher: American Medical Association  
Date Published: 2019-11-01
Start Page: 1620
End Page: 1627
Language: English
DOI: 10.1001/jamaoncol.2019.2585
PUBMED: 31436828
PROVIDER: scopus
Notes: Source: Scopus
Citation Impact
MSK Authors
  1. Neil Mukund Iyengar
    80 Iyengar
  2. Lee Winston Jones
    129 Jones