Exercising and immuno-oncology treatment (ExIO): a prospective pilot study for patients with solid tumors

Abstract

Purpose: Despite exercise's known benefits for cancer patients, little is understood about combining it with immune checkpoint inhibitors (ICI). This study aims to assess the feasibility and acceptability of a personalized physical activity program for cancer patients on ICI treatment and to investigate its effects on quality of life, ICI-related side effects, fatigue, and emotional symptoms.

Methods: This prospective study was conducted across eight cancer practices in a joint network in Brazil. Eligible cancer patients undergoing ICIs were recruited from June 2022 to January 2023. Participants completed a 12-week physical activity program with remote supervision. Baseline and 12-week assessments utilized the FACT-ICM, BFI, ESAS, PROMIS-Anxiety, and FCR-7 scales. Feasibility and acceptability were evaluated based on enrollment, retention, and adherence rates, with patient feedback collected at week 12. Linear mixed models were employed to assess outcomes.

Results: Out of 38 patients, 81% showed high adherence, 62% engaged in activities more than 4 days weekly, and 97% were satisfied with the program. The sample was mostly female (55%), median age of 60.5, primarily diagnosed with breast cancer (26%) and renal cell carcinoma (24%), with 60.5% having metastatic cancer. Sixty percent received ICI combined with chemotherapy. Significant improvements were observed over time in treatment-related side effects, emotional symptoms, and quality of life (p < 0.001).

Conclusion: These findings endorse integrating an exercise program with remote supervision into the care of cancer patients undergoing ICI treatment. This intervention may positively impact symptom management and quality of life, offering a cost-effective approach in oncologic treatment and survivorship care globally.

Keywords: Cancer; Exercise; Oncology; Physical activity.