Physical activity levels are positively related to progression-free survival and reduced adverse events in advanced ER + breast cancer.

Autor: Zimmer P; Institute for Sport and Sport Science, Division of Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany. philipp.zimmer@tu-dortmund.de., Esser T; Institute for Sport and Sport Science, Division of Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany., Lueftner D; Immanuel Hospital Märkische Schweiz, AND Medical University of Brandenburg Theodor Fontane, BuckowRüdersdorf Bei Berlin, Germany., Schuetz F; Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany., Baumann FT; Department I of Internal Medicine, Center for Integrated Oncology, University Hospital of Cologne, Cologne, Germany., Rody A; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Lübeck, Germany., Schneeweiss A; National Center for Tumor Diseases (NCT), Heidelberg University Hospital and German Cancer Research Center, Heidelberg, Germany., Hartkopf AD; Dpt. of Women's Health, University Hospital Tuebingen, Tuebingen, Germany., Decker T; Medical Center for Hematology and Oncology Ravensburg, Ravensburg, Germany., Uleer C; Gynecologic Group Practice, Hildesheim, Germany., Stoetzer OJ; Medical Center for Hematology and Oncology Munich, Munich, Germany., Foerster F; Poliklinik GmbH Chemnitz, Chemnitz, Germany., Schmidt M; Dpt. of Obstetrics and Gynecology, Dpt. of Conservative and Molecular Gynecological Oncology, University Medical Center Mainz, Mainz, Germany., Mundhenke C; Department of Obstetrics and Gynecology, Bayreuth Hospital, Bayreuth, Germany., Steindorf K; German Cancer Research Center, Division of Physical Activity, Prevention and Cancer, Heidelberg, Germany., Tesch H; Center for Hematology and Oncology Bethanien, Frankfurt, Germany., Jackisch C; Dpt. of Obstetrics and Gynecology, Sana Klinikum Offenbach, Offenbach, Germany., Fischer T; Winicker Norimed GmbH Medical Research, Nuernberg, Germany., Hanson S; Novartis Pharma GmbH, Nuernberg, Germany., Kreuzeder J; Novartis Pharma GmbH, Nuernberg, Germany., Guderian G; Novartis Pharma GmbH, Nuernberg, Germany., Fasching PA; Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany., Bloch W; Dpt. for Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany.
Jazyk: angličtina
Zdroj: BMC medicine [BMC Med] 2024 Oct 08; Vol. 22 (1), pp. 442. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1186/s12916-024-03671-x
Abstrakt: Background: Increased levels of physical activity are associated with a reduction of breast cancer mortality, especially in postmenopausal women with positive hormone receptor status. So far, previous observational case-control and cohort studies have focused on associations between overall leisure time physical activity and survival of women with breast cancer in general.
Methods: In this multicenter prospective cohort study, conducted in Germany between 30th August 2012 to 29th December 2017, we investigated general physical activity in a homogenous sample of n = 1440 postmenopausal women with advanced (inoperable locally advanced or metastatic), hormone receptor-positive breast cancer receiving the same therapy (everolimus and exemestane). Self-reported physical activity was assessed using the Godin Leisure Time Exercise Questionnaire (GLTEQ) before and every 3 months during treatment. Participants were then classified into "active" and "insufficiently active" to screen their activity behavior the week prior to medical treatment. In addition, changes in physical activity patterns were assessed. Adjusted Cox regression analyses were performed for the activity categories to determine hazard ratios (HR). Besides progression-free survival (PFS), adverse events (AEs), QoL, and fatigue were assessed every 3 months until study termination.
Results: Compared to "insufficiently active" patients, "active" individuals indicated a significantly longer PFS (HR: 0.84 [0.74; 0.984], p = .0295). No significant differences were observed for changes of physical activity behavior. Patients who reported to be "active" at baseline revealed significantly fewer AEs compared to "insufficiently" active patients. In detail, both severe and non-severe AEs occurred less frequently in the "active" patients group. In line with that, QoL and fatigue were better in physical "active" patients compared to their insufficient active counterparts at the last post-baseline assessment. Participants who remained or become active indicated less AEs, a higher QoL, and reduced fatigue levels.
Conclusions: Physical activity behavior prior to medical treatment might have prognostic value in patients with advanced breast cancer in terms of extending the PFS. Moreover, physical activity before and during treatment may reduce treatment-related side effects and improve patients' QoL and fatigue.
Trial Registration: EUPAS9462. Registered 30th October 2012 "retrospectively registered."
(© 2024. The Author(s).)
Databáze: MEDLINE
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