Key result
Supervised moderate-intensity exercise preserves LVEF and 6MWD during trastuzumab therapy compared to usual care.
Why the study?
Cardiotoxicity is a severe oncological complication that limits therapy, and whether moderate-intensity exercise training prevents trastuzumab-induced heart failure and functional decline remained unclear.
Does supervised moderate-intensity exercise training prevent trastuzumab-induced cardiotoxicity (LVEF decline) and physical capacity reduction in women with HER2-positive breast cancer?
RCT (n=47)
Single-blind (assessors and statistician blinded)
Computer-generated list of random numbers (simple randomization)
No
Does supervised moderate-intensity exercise training prevent trastuzumab-induced cardiotoxicity (LVEF decline) and physical capacity reduction in women with HER2-positive breast cancer?
p-value: p=<0.05
Moderate-intensity exercise training may prevent the decline in left ventricular ejection fraction and physical capacity associated with trastuzumab therapy in women with HER2-positive breast cancer.
Supports supervised exercise to preserve LVEF and capacity on trastuzumab; extends RCT evidence for cardio-oncology prevention.
Cardiotoxicity is known as a severe clinical problem in oncological practice that reduces the options for cancer therapy. Physical exercise is recognized as a well-established protective measure for many heart and cancer diseases. In our study, we hypothesized that supervised and moderate-intensity exercise training would prevent heart failure and its consequences induced by trastuzumab therapy. The aim of this study was to examine the effect of physical training on ventricular remodeling, serum cardiac markers, and exercise performance in women with human epidermal growth receptor 2 (HER2+) breast cancer (BC) undergoing trastuzumab therapy. This was a prospective, randomized, clinical controlled trial. Forty-six BC women were randomized into either an intervention group (IG) or a control group (CG). An exercise program (IG) was performed after 3–6 months of trastuzumab therapy at 5 d/week (to 80% maximum heart rate (HRmax)) for 9 weeks. We then evaluated their cardiac function using echocardiography, a 6-Minute Walk Test (6MWT), and plasma parameters (C-reactive protein (CRP), myoglobin (MYO), interleukin-6 (IL-6), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatine kinase (CK)). After the physical training program, we did not observe any significant changes in the left ventricular (LV) ejection fraction (LVEF) and 6MWT (p > 0.05) in the IG compared to the CG (decrease p < 0.05). The differences in the blood parameters were not significant (p < 0.05). To conclude, moderate-intensity exercise training prevented a decrease in the LVEF and physical capacity during trastuzumab therapy in HER2+ BC. Further research is needed to validate our results.
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Hojan et al. (2020) conducted an RCT in HER2-positive breast cancer undergoing trastuzumab therapy (n=47). Supervised moderate-intensity exercise training (endurance and strength) vs. Usual care was evaluated on Differences in cardiac function (LVEF) and physical capacity (6MWT) over 9 weeks (p=<0.05). A 9-week supervised moderate-intensity exercise program prevented significant decreases in left ventricular ejection fraction and 6-minute walk distance compared to usual care in women with HER2-positive breast cancer undergoing trastuzumab therapy.
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