Dose-Response Effects of Aerobic Exercise among Colon Cancer Survivors: A Randomized Phase II Trial

• Published in: Clinical colorectal cancer Vol. 17; no. 1; pp. 32 - 40
• Main Authors: Brown, Justin C., PhD, Troxel, Andrea B., ScD, Ky, Bonnie, MD, Damjanov, Nevena, MD, Zemel, Babette S., PhD, Rickels, Michael R., MD, Rhim, Andrew D., MD, Rustgi, Anil K., MD, Courneya, Kerry S., PhD, Schmitz, Kathryn H., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2018
• Subjects: Adult; Aged; Amine Oxidase (Copper-Containing) - blood; Biomarkers; Biomarkers, Tumor - analysis; Cancer Survivors; Cell Adhesion Molecules - blood; Colonic Neoplasms; Energy balance; Exercise; Exercise Therapy - methods; Female; Gastroenterology and Hepatology; Hematology, Oncology and Palliative Medicine; Humans; Intercellular Adhesion Molecule-1 - blood; Lifestyle; Male; Middle Aged; Neoplasm Recurrence, Local - prevention & control; Physical activity; Survivorship; survivorship; energy balance; biomarkers; physical activity; lifestyle; Biomarkers; Energy balance; Lifestyle; Physical activity; Survivorship
• ISSN: 1533-0028; 1938-0674
• DOI: 10.1016/j.clcc.2017.06.001

Abstract Background Observational studies suggest that higher volumes of physical activity are associated with a lower risk of disease recurrence among colon cancer survivors. However, the feasibility and safety of prescribing higher volumes of physical activity to colon cancer survivors are unknown. Furthermore, the pathways through which exercise may reduce disease recurrence are unknown. Patients and Methods Stage I-III colon cancer survivors were randomized to usual-care control, 150 min∙wk-1 of aerobic exercise (low-dose), or 300 min∙wk-1 of aerobic exercise (high-dose). Changes in soluble intercellular adhesion molecule-1 (sICAM-1) and vascular adhesion molecule-1 (sVCAM-1) prognostic biomarkers were examined. Results From January 2015 to February 2016, 39 patients were enrolled ( n =13 usual-care control; n =14 low-dose; n =12 high-dose) and 38 participants completed the study (97% follow-up). Over six-months, the low-dose group completed 142 min∙wk-1 (92.8% adherence) and the high-dose group completed 247 min∙wk-1 (89.0% adherence) of exercise. Compared to the control group, changes in sICAM-1 were −134.9 ng/mL (95% CI: −238.1 to −31.6) in the low-dose group and −114.8 ng/mL (95% CI: −222.5 to −7.1) in the high-dose group (linear Ptrend =0.023; nonlinear Ptrend =0.044). No changes were observed for sVCAM-1 (linear Ptrend =0.791; nonlinear Ptrend =0.604). Non-serious adverse events occurred at similar rates among randomized groups. No serious adverse events occurred. Conclusion Higher volumes of moderate-intensity aerobic exercise, up to 300 min∙wk-1 , are feasible, safe, and elicit favorable changes in prognostic biomarkers among patients recently treated for stage I-III colon cancer. These data can be used to guide clinical recommendations for patients, and inform future trials.