Supervised, structured and individualized exercise in metastatic breast cancer : A randomized controlled trial
Journal article
Hiensch, Anouk E., Depenbusch, Johanna, Schmidt, Martina E., Monninkhof, Evelyn M., Pelaez, Mireia, Clauss, Dorothea, Gunasekara, Nadira, Zimmer, Philipp, Belloso, Jon, Trevaskis, Mark, Rundqvist, Helene, Wiskemann, Joachim, Müller, Jana, Sweegers, Maike G., Fremd, Carlo, Altena, Renske, Gorecki, Maciej, Bijlsma, Rhodé, van Leeuwen-Snoeks, Lobke, ... May, Anne M.. (2024). Supervised, structured and individualized exercise in metastatic breast cancer : A randomized controlled trial. Nature Medicine. 30(10), pp. 2957-2966. https://doi.org/10.1038/s41591-024-03143-y
Authors | Hiensch, Anouk E., Depenbusch, Johanna, Schmidt, Martina E., Monninkhof, Evelyn M., Pelaez, Mireia, Clauss, Dorothea, Gunasekara, Nadira, Zimmer, Philipp, Belloso, Jon, Trevaskis, Mark, Rundqvist, Helene, Wiskemann, Joachim, Müller, Jana, Sweegers, Maike G., Fremd, Carlo, Altena, Renske, Gorecki, Maciej, Bijlsma, Rhodé, van Leeuwen-Snoeks, Lobke, ten Bokkel Huinink, Daan, Sonke, Gabe, Lahuerta, Ainhara, Mann, G. Bruce, Francis, Prudence A., Richardson, Gary, Malter, Wolfram, van der Wall, Elsken, Aaronson, Neil K., Senkus, Elzbieta, Urruticoechea, Ander, Zopf, Eva M., Bloch, Wilhelm, Stuiver, Martijn M., Wengström, Yvonne, Steindorf, Karen and May, Anne M. |
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Abstract | Physical exercise both during and after curative cancer treatment has been shown to reduce side effects. Evidence in the metastatic cancer setting is scarce, and interventions that improve health-related quality of life (HRQOL) are much needed for patients with metastatic breast cancer (MBC). The multinational randomized controlled PREFERABLE-EFFECT trial assessed the effects of exercise on fatigue and HRQOL in patients with MBC. In total, 357 patients with MBC and a life expectancy of ≥6 months but without unstable bone metastases were recruited at eight study centers across five European countries and Australia. Participants were randomly assigned (1:1) to usual care (control group, n = 179) or a 9-month supervised exercise program (exercise group, n = 178). Intervention effects on physical fatigue (European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-FA12 scale) and HRQOL (EORTC QLQ-C30 summary score) were determined by comparing the change from baseline to 3, 6 (primary timepoint) and 9 months between groups using mixed models for repeated measures, adjusted for baseline values of the outcome, line of treatment (first or second versus third or higher) and study center. Exercise resulted in significant positive effects on both primary outcomes. Physical fatigue was significantly lower (−5.3 (95% confidence interval (CI), −10.0 to −0.6), Bonferroni–Holm-adjusted P = 0.027; Cohen's effect size, 0.22) and HRQOL significantly higher (4.8 (95% CI, 2.2–7.4), Bonferroni–Holm-adjusted P = 0.0003; effect size, 0.33) in the exercise group than in the control group at 6 months. Two serious adverse events occurred (that is, fractures), but both were not related to bone metastases. These results demonstrate that supervised exercise has positive effects on physical fatigue and HRQOL in patients with MBC and should be recommended as part of supportive care. |
Year | 2024 |
Journal | Nature Medicine |
Journal citation | 30 (10), pp. 2957-2966 |
Publisher | Springer Nature |
ISSN | 1078-8956 |
Digital Object Identifier (DOI) | https://doi.org/10.1038/s41591-024-03143-y |
PubMed ID | 39054374 |
Scopus EID | 2-s2.0-85199661397 |
PubMed Central ID | PMC11485212 |
Open access | Published as ‘gold’ (paid) open access |
Page range | 2957-2966 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 25 Jul 2024 |
Publication process dates | |
Accepted | 20 Jun 2024 |
Deposited | 06 May 2025 |
Additional information | © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
https://acuresearchbank.acu.edu.au/item/91v5z/supervised-structured-and-individualized-exercise-in-metastatic-breast-cancer-a-randomized-controlled-trial
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