LBA22 - Connected device and therapeutic patient education to promote physical activity among in women with localized breast cancer: Results from the DISCO randomized trial

Background

Despite benefits of physical activity (PA) during breast cancer (BC) treatments, successful exercise strategies in routine BC care remain to be determined. The primary objective was to assess the efficacy of two 6-month PA interventions: connected PA program and therapeutic patient education (TPE), concomitant to adjuvant treatments.

Methods

DISCO was a 2x2 factorial, multicenter, phase III, randomized controlled trial. Women with a localized invasive BC and eligible for any adjuvant treatment, were randomized in 1 of the 4 groups: web-based connected device (adaptative program of 2 walking and 1 muscle strengthening sessions/week in autonomy + a connected activity wristband); TPE (2 sessions); combination of both interventions; usual care. All patients received PA recommendations. Assessments (baseline, 6&12 months) included physical fitness, body composition and questionnaires. The primary endpoint was the proportion of patients who reached PA recommendations at 6 months based on the Recent Physical Activity Questionnaire, in each intervention compared to patients who did not receive it. Statistical analyses were performed in the ITT population.

Results

From 2018 to 2021, 436 patients were randomized: 108 patients received the connected device, 108 the TPE program, 110 both interventions, and 110 usual care. At baseline, 66% of patients reached PA recommendations. During the 6-month intervention, 96% of patients wore the connected device, the median number of PA sessions was 45 and 80% of patients attended the TPE program. Overall, 89,3% of patients who received the connected device reached PA recommendations at 6 months vs. 89,4% of patients without the device and 91,9% of patients who benefits from TPE reached PA recommendations vs. 87% of patients without TPE. For the primary endpoint, no statistically significant difference was found for both interventions.

Conclusions

The findings provide new information on the efficacy of innovative interventions to practice PA during routine BC treatment. The 6-month major increase of PA, independently of patient group allocation, highlights the importance of providing PA recommendations and PA assessment to BC patients.

Clinical trial identification

NCT03529383; release date: 05/17/2018.

Editorial acknowledgement

Legal entity responsible for the study

Centre Léon Bérard.

Funding

Fondation ARC and the French National Cancer Institute (grant no. PREV201601260); Foundation for Medical Research (grant no. DOC20161136212); “Métropole de Lyon / Cancéropôle Lyon Auvergne Rhône-Alpes” (grant no. 2016 Projet Structurant) and AG2R La Mondiale.

Disclosure

T. Bachelot: Financial Interests, Personal, Financially compensated role: Seagen, Pfizer, AstraZeneca/Daiichi Sankyo, Novartis, Lilly; Financial Interests, Institutional, Research Grant: Seagen, Pfizer, AstraZeneca/Daiichi Sankyo, Novartis; Non-Financial Interests, Personal, Advisory Board: Pfizer. J. Blay: Financial Interests, Institutional, Coordinating PI: LYRICAN; Financial Interests, Institutional, Leadership Role: Institut Convergence, Euracan (european commission). All other authors have declared no conflicts of interest.