1812MO - Effects of oncologic rehabilitation during adjuvant endocrine therapy in overweight or obese patients with breast cancer

Background

Treatment with adjuvant endocrine therapy (ET) in patients with breast cancer (BC) increases the risk of becoming less physically active and weight gain. A high body mass index (BMI) and physical inactivity are both independently associated with a higher risk of cancer-related side-effects and mortality. Effects of oncologic rehabilitation on physical activity (PA) in this specific patient population is unknown. This study investigated whether oncologic rehabilitation increased PA in patients receiving adjuvant ET for BC.

Methods

Eligible patients for this multicenter, prospective clinical trial were female, aged 18-75, receiving adjuvant ET for BC, and with a BMI ≥ 25 (NCT02424292). All patients attended a 12-week moderate-intensity aerobic- and resistance exercise program. Moderate to vigorous PA (MVPA) was measured by an accelerometer at baseline (T0), after 12 and 26 weeks (T1 and T2). Primary endpoint was change in proportion of patients with weekly ≥ 150 minutes of MVPA (national guideline recommendations), at T1 compared to T0. Secondary endpoints were metabolic syndrome (MetS), body composition, health-related quality of life (HRQoL) and breast cancer-specific functioning and symptoms (EORTC QLQ-C30 and QLQ-BR23), self-reported PA (PASE), self-efficacy (ALCOS), exercise motivation (PACE) and overall satisfaction with life.

Results

In total, 141 patients with a median age of 61 yrs [54-66] and mean BMI of 31.3 ± 4.4 participated. Proportion of patients with weekly ≥ 150 minutes of MVPA increased from 38.6% at T0, to 48.7% at T1 and 56.3% at T2 [χ²(2) = 8.977, p = .011]. Moreover, MetS, body composition and symptoms (i.e. fatigue) significantly decreased while HRQoL, functioning, self-reported PA, self-efficacy, exercise motivation and satisfaction with life all increased significantly at T1 and T2 compared to T0.

Conclusions

Oncologic rehabilitation significantly increased PA and HRQoL in overweight or obese BC patients, receiving adjuvant ET. Furthermore, MetS, body composition and fatigue significantly decreased. Our findings highlight the beneficial effect of oncologic rehabilitation in these patients, who are particularly vulnerable for poor health outcome.

Clinical trial identification

NCT02424292.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Supported by the Dutch Pink Ribbon foundation (grant number 2011.WO43.C116).

Disclosure

All authors have declared no conflicts of interest.