PURPOSE: Cancer cachexia affects up to 80% of patients with advanced cancer. While exercise has shown benefits for early-stage cancer patients, its role in managing cachexia remains unclear. This study examined whether severe weight loss impedes the benefits of exercise in cancer patients. METHODS: This prospective study analyzed the feasibility and efficacy of a 12-week supervised exercise program in cancer patients with BMI-adjusted weight loss grades 3-4. Feasibility was the primary outcome and was evaluated through attrition, attendance, and safety, while secondary outcomes included changes in nutritional status, physical performance, exercise levels, and fatigue. Outcomes were compared with those of matched cancer patients without advanced BMI-adjusted weight loss who followed the same exercise program. RESULTS: Twenty-three patients with BMI-adjusted weight loss grades 3-4 were enrolled and 14 completed the program, attending an average of 17.1 ± 4.3/24 sessions. No adverse events occurred. Intervention improved endurance (+7.06% of theoretical 6MWT distance, p < 0.001). Positive trends emerged for lower limb strength (+2.69 repetitions at 30-s sit-to-stand test, p = 0.005), lean mass (+1.78 kg, p = 0.003), and dietary intake (+ 2.5/10 SEFI, p = 0.003). Functional benefits were also observed in patients without weight loss (n = 14, endurance = +11.33%, lower limb strength = +4, p < 0.001). CONCLUSION: The exercise intervention demonstrated promising efficacy in managing cancer weight loss, providing benefits like those observed in non-cachectic patients, with added gains in nutritional status. While no exercise-related adverse events occurred, feasibility criteria were only partially met due to a higher-than-expected attrition rate. Further research is needed to optimize recruitment strategies, energetic balance, and tailor interventions for this population. TRIAL REGISTRATION: The study is registered on ClinicalTrial.gov (Trial registration: NCT06651125).
Richard et al. (2026) studied this question.