Effects of exercise therapy on chemotherapy delivery and response in primary breast cancer: A secondary analysis of a randomized trial Journal Article
| Authors: | Iyengar, N. M.; Scott, J. M.; Lee, J.; Lavery, J. A.; Foug, K. L.; Lee, C. P.; Michalski, M. G.; Chun, S. S.; Harrison, J.; Moskowitz, C. S.; Jones, L. W. |
| Article Title: | Effects of exercise therapy on chemotherapy delivery and response in primary breast cancer: A secondary analysis of a randomized trial |
| Abstract: | Background: Whether structured exercise therapy improves chemotherapy delivery, tolerability, and tumor response is unclear. Methods: This was a secondary analysis of a phase 2 trial investigating exercise therapy (n = 72) versus usual care (n = 72) in patients with primary breast cancer. Exercise therapy comprised individualized treadmill walking three times weekly for 20–50 minutes per session at 55%–100% of pretreatment exercise capacity. Chemotherapy delivery was assessed according to the relative dose intensity (RDI), tolerability was assessed according to patient-reported outcomes and blood laboratory values, and response was assessed based on the pathologic complete response rate in patients who received neoadjuvant chemotherapy. Results: In the exercise therapy group, 51 patients (71%) reached 100% RDI (median, 100%; interquartile range, 100%–100%) compared with 41 patients (57%) in the usual care group (median, 100%; interquartile range, 95%–100%; p =.08). Tolerability was similar in both groups; the rates of grade 3 or higher neutropenia and anemia were 22% versus 39% and 7% versus 10% in the exercise and usual care groups, respectively. In patients who received anthracyclines (n = 104), 41 (77%) had 100% chemotherapy RDI in the exercise therapy group versus 29 (57%) in the usual care group (p =.026). In the neoadjuvant chemotherapy subgroup (n = 51 tumors), the postneoadjuvant therapy (yp) pathologic complete response (ypT0ypN0) rate was 27% (95% confidence interval, 12%–50%) in the exercise therapy group compared with 28% (95% confidence interval, 13%–47%) in the usual care group (p >.9). Conclusions: In patients with primary breast cancer, exercise therapy was associated with improved delivery of anthracycline-based chemotherapy. Although exercise therapy was not significantly associated with tumor response, effects varied by tumor subtype (trial registration: Clinicaltrials.gov identifier NCT01943695). © 2024 American Cancer Society. |
| Keywords: | adult; controlled study; treatment outcome; treatment response; aged; middle aged; major clinical study; clinical trial; drug tolerability; neutropenia; doxorubicin; paclitaxel; neoadjuvant therapy; cancer staging; nuclear magnetic resonance imaging; antineoplastic agent; phase 2 clinical trial; breast cancer; anemia; mastectomy; tumor volume; randomized controlled trial; antineoplastic combined chemotherapy protocols; epidermal growth factor receptor 2; cohort analysis; exercise; cyclophosphamide; pathology; breast neoplasms; health care quality; body mass; mammography; breast tumor; echography; epirubicin; blood cell count; neoadjuvant chemotherapy; tumor growth; drug therapy; anthracycline; hormone receptor; anthracyclines; therapy; treadmill exercise; race; lumpectomy; kinesiotherapy; secondary analysis; randomized controlled trial (topic); phase 2 clinical trial (topic); exercise therapy; patient-reported outcome; brief pain inventory; procedures; oncological parameters; pittsburgh sleep quality index; cardiorespiratory fitness; functional assessment of cancer therapy breast; humans; human; female; article; functional assessment of chronic illness therapy fatigue scale; functional assessment of cancer therapy general; peak oxygen uptake; chemotherapy delivery; chemotherapy tolerability; pathologic complete response rate |
| Journal Title: | Cancer |
| Volume: | 131 |
| Issue: | 1 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2025-01-01 |
| Start Page: | e35575 |
| Language: | English |
| DOI: | 10.1002/cncr.35575 |
| PUBMED: | 39306704 |
| PROVIDER: | scopus |
| PMCID: | PMC11695174 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding authors are Neil Iyengar and Lee Jones -- Source: Scopus |
