Adherence, safety and satisfaction of a cardio-oncology rehabilitation program framework versus community exercise training for cancer survivors: findings from the CORE trial

Purpose To assess safety, satisfaction and overall adherence of a cardiac rehabilitation (CR) based framework for cancer patients at increased cardiovascular (CV) risk, compared to a community-based exercise training (CBET) Methods The CORE study (NCT05132998) was a single-center, prospective, randomized controlled trial enrolling cancer survivors exposed to cardiotoxic cancer treatment and/or with previous CV disease. Participants were randomized to an eight-week center-based CR program (CBCR) or CBET, twice a week. Overall feasibility (consent, retention, and completion rates) as well as intervention adherence (percentage of exercise session attended) and safety were assessed. Adverse events (AEs) were registered, and patients’ satisfaction was measured at the end of the study through a 5-item questionnaire. Results Eighty patients were included. The consent rate was 72.4%, and 77 (96.2%) patients started the study (retention rate 100% in CBCR vs 92.5% in CBET). The completion rate was 92.5%. Intervention adherence was higher in CBCR (90.3 ± 11.8% vs 68.4 ± 22.1%, p < 0.001). Exercise-related AEs were mainly musculoskeletal, accounting for exercise prescription modification in 47 sessions, none of them motivating exercise discontinuation. Major CV events were not reported. Patients revealed higher satisfaction in the CBCR (86.8% reported being very satisfied with the program vs 45.9% in CBET, p < 0.001). Conclusion The CORE trial suggests that both exercise-based interventions are feasible and safe in this setting. The higher intervention adherence and patient satisfaction in the CBCR group suggests that this comprehensive approach could be of interest in this patient population.