Effects of exercise during adjuvant chemotherapy on breast cancer outcomes
Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (ST...
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Published in | Medicine and science in sports and exercise Vol. 46; no. 9; p. 1744 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.09.2014
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Abstract | Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (START).
The START was a Canadian multicenter trial that randomized 242 breast cancer patients between 2003 and 2005 to usual care (n = 82), supervised aerobic (n = 78), or resistance (n = 82) exercise during chemotherapy. The primary end point for this exploratory analysis was disease-free survival (DFS). Secondary end points were overall survival, distant DFS, and recurrence-free interval. The two exercise arms were combined for analysis (n = 160), and selected subgroups were explored.
After a median follow-up of 89 months, there were 25/160 (15.6%) DFS events in the exercise groups and 18/82 (22.0%) in the control group. Eight-year DFS was 82.7% for the exercise groups compared with 75.6% for the control group (HR, 0.68; 95% confidence interval (CI), 0.37-1.24; log-rank, P = 0.21). Slightly stronger effects were observed for overall survival (HR, 0.60; 95% CI, 0.27-1.33; log-rank, P = 0.21), distant DFS (HR, 0.62; 95% CI, 0.32-1.19; log-rank, P = 0.15), and recurrence-free interval (HR, 0.58; 95% CI, 0.30-1.11; Gray test, P = 0.095). Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese (HR, 0.59; 95% CI, 0.27-1.27), had stage II/III cancer (HR, 0.61; 95% CI, 0.31-1.20), estrogen receptor-positive tumors (HR, 0.58; 95% CI, 0.26-1.29), human epidermal growth factor receptor 2-positive tumors (HR, 0.21; 95% CI, 0.04-1.02), received taxane-based chemotherapies (HR, 0.46; 95% CI, 0.19-1.15), and ≥85% of their planned chemotherapy (HR, 0.50; 95% CI, 0.25-1.01).
This exploratory follow-up of the START provides the first randomized data to suggest that adding exercise to standard chemotherapy may improve breast cancer outcomes. A definitive phase III trial is warranted. |
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AbstractList | Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (START).
The START was a Canadian multicenter trial that randomized 242 breast cancer patients between 2003 and 2005 to usual care (n = 82), supervised aerobic (n = 78), or resistance (n = 82) exercise during chemotherapy. The primary end point for this exploratory analysis was disease-free survival (DFS). Secondary end points were overall survival, distant DFS, and recurrence-free interval. The two exercise arms were combined for analysis (n = 160), and selected subgroups were explored.
After a median follow-up of 89 months, there were 25/160 (15.6%) DFS events in the exercise groups and 18/82 (22.0%) in the control group. Eight-year DFS was 82.7% for the exercise groups compared with 75.6% for the control group (HR, 0.68; 95% confidence interval (CI), 0.37-1.24; log-rank, P = 0.21). Slightly stronger effects were observed for overall survival (HR, 0.60; 95% CI, 0.27-1.33; log-rank, P = 0.21), distant DFS (HR, 0.62; 95% CI, 0.32-1.19; log-rank, P = 0.15), and recurrence-free interval (HR, 0.58; 95% CI, 0.30-1.11; Gray test, P = 0.095). Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese (HR, 0.59; 95% CI, 0.27-1.27), had stage II/III cancer (HR, 0.61; 95% CI, 0.31-1.20), estrogen receptor-positive tumors (HR, 0.58; 95% CI, 0.26-1.29), human epidermal growth factor receptor 2-positive tumors (HR, 0.21; 95% CI, 0.04-1.02), received taxane-based chemotherapies (HR, 0.46; 95% CI, 0.19-1.15), and ≥85% of their planned chemotherapy (HR, 0.50; 95% CI, 0.25-1.01).
This exploratory follow-up of the START provides the first randomized data to suggest that adding exercise to standard chemotherapy may improve breast cancer outcomes. A definitive phase III trial is warranted. |
Author | Segal, Roanne J Mackey, John R Dong, Huiru Gelmon, Karen Courneya, Kerry S McKenzie, Donald C Reid, Robert D Friedenreich, Christine M Yasui, Yutaka Crawford, Jennifer J |
Author_xml | – sequence: 1 givenname: Kerry S surname: Courneya fullname: Courneya, Kerry S organization: 1Faculty of Physical Education, University of Alberta, Edmonton, Alberta, CANADA; 2Ottawa Hospital Regional Cancer Center, Ottawa, Ontario, CANADA; 3School of Kinesiology, University of British Columbia, Vancouver, British Columbia, CANADA; 4British Columbia Cancer Agency, Vancouver, British Columbia, CANADA; 5Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, CANADA; 6University of Ottawa Heart Institute, Ottawa, Ontario, CANADA; and 7Cross Cancer Institute, Edmonton, Alberta, CANADA – sequence: 2 givenname: Roanne J surname: Segal fullname: Segal, Roanne J – sequence: 3 givenname: Donald C surname: McKenzie fullname: McKenzie, Donald C – sequence: 4 givenname: Huiru surname: Dong fullname: Dong, Huiru – sequence: 5 givenname: Karen surname: Gelmon fullname: Gelmon, Karen – sequence: 6 givenname: Christine M surname: Friedenreich fullname: Friedenreich, Christine M – sequence: 7 givenname: Yutaka surname: Yasui fullname: Yasui, Yutaka – sequence: 8 givenname: Robert D surname: Reid fullname: Reid, Robert D – sequence: 9 givenname: Jennifer J surname: Crawford fullname: Crawford, Jennifer J – sequence: 10 givenname: John R surname: Mackey fullname: Mackey, John R |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24633595$$D View this record in MEDLINE/PubMed |
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Snippet | Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data... |
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SubjectTerms | Antineoplastic Agents - therapeutic use Breast Neoplasms - complications Breast Neoplasms - drug therapy Breast Neoplasms - pathology Bridged-Ring Compounds - therapeutic use Chemotherapy, Adjuvant Combined Modality Therapy - methods Disease-Free Survival Exercise Therapy - methods Female Follow-Up Studies Humans Middle Aged Neoplasm Staging Obesity - complications Receptors, Estrogen - analysis Resistance Training Survival Rate Taxoids - therapeutic use Treatment Outcome |
Title | Effects of exercise during adjuvant chemotherapy on breast cancer outcomes |
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