Structured Exercise after Adjuvant Chemotherapy for Colon Cancer. Journal Articles uri icon

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abstract

  • BACKGROUND: Preclinical and observational studies suggest that exercise may improve cancer outcomes. However, definitive level 1 evidence is lacking. METHODS: In this phase 3, randomized trial conducted at 55 centers, we assigned patients with resected colon cancer who had completed adjuvant chemotherapy to participate in a structured exercise program (exercise group) or to receive health-education materials alone (health-education group) over a 3-year period. The primary end point was disease-free survival. RESULTS: From 2009 through 2024, a total of 889 patients underwent randomization to the exercise group (445 patients) or the health-education group (444 patients). At a median follow-up of 7.9 years, disease-free survival was significantly longer in the exercise group than in the health-education group (hazard ratio for disease recurrence, new primary cancer, or death, 0.72; 95% confidence interval [CI], 0.55 to 0.94; P = 0.02). The 5-year disease-free survival was 80.3% in the exercise group and 73.9% in the health-education group (difference, 6.4 percentage points; 95% CI, 0.6 to 12.2). Results support longer overall survival in the exercise group than in the health-education group (hazard ratio for death, 0.63; 95% CI, 0.43 to 0.94). The 8-year overall survival was 90.3% in the exercise group and 83.2% in the health-education group (difference, 7.1 percentage points; 95% CI, 1.8 to 12.3). Musculoskeletal adverse events occurred more often in the exercise group than in the health-education group (in 18.5% vs. 11.5% of patients). CONCLUSIONS: A 3-year structured exercise program initiated soon after adjuvant chemotherapy for colon cancer resulted in significantly longer disease-free survival and findings consistent with longer overall survival. (Funded by the Canadian Cancer Society and others; CHALLENGE ClinicalTrials.gov number, NCT00819208.).

authors

  • Courneya, Kerry S
  • Vardy, Janette L
  • O'Callaghan, Christopher J
  • Gill, Sharlene
  • Friedenreich, Christine M
  • Wong, Rebecca KS
  • Dhillon, Haryana M
  • Coyle, Victoria
  • Chua, Neil S
  • Jonker, Derek J
  • Beale, Philip J
  • Haider, Kamal
  • Tang, Patricia A
  • Bonaventura, Tony
  • Wong, Ralph
  • Lim, Howard J
  • Burge, Matthew E
  • Hubay, Stacey
  • Sanatani, Michael
  • Campbell, Kristin L
  • Arthuso, Fernanda Z
  • Turner, Jane
  • Meyer, Ralph
  • Brundage, Michael
  • O'Brien, Patti
  • Tu, Dongsheng
  • Booth, Christopher M
  • CHALLENGE Investigators

publication date

  • July 3, 2025