Key result
Resistance and high-intensity interval training during breast cancer chemotherapy significantly reduced the odds of fulfilling biomarker risk criteria for decreased cardiac function compared to usual care (OR 0.200).
Why the study?
Adjuvant systemic breast cancer treatment improves disease-specific outcomes but presents with cardiac toxicity, prompting evaluation of the effects of exercise on cardiotoxicity.
Does high-intensity exercise prevent long-term myocardial damage and preserve physical capacity in women undergoing breast cancer chemotherapy?
RCT (n=88)
Open-label
Randomized
Yes
Does high-intensity exercise prevent long-term myocardial damage and preserve physical capacity in women undergoing breast cancer chemotherapy?
Odds Ratio: 0.2 (95% CI 0.055–0.734)
p-value: p=0.04
High-intensity exercise during breast cancer chemotherapy is associated with lower long-term NT-proBNP levels and preserved physical capacity in patients with low biomarker release, suggesting a cardioprotective effect.
Supports incorporating resistance and HIIT into breast cancer chemotherapy to lower cardiac risk; extends RCT evidence for exercise in cardio-oncology.
Background Adjuvant systemic breast cancer treatment improves disease specific outcomes, but also presents with cardiac toxicity. In this post-hoc exploratory analysis of the OptiTrain trial, the effects of exercise on cardiotoxicity were monitored by assessing fitness and biomarkers over the intervention and into survivorship. Methods; Women starting chemotherapy were randomized to 16-weeks of resistance and high-intensity interval training (RT-HIIT), moderate-intensity aerobic and high-intensity interval training (AT–HIIT), or usual care (UC). Outcome measures included plasma troponin-T (cTnT), Nt-pro-BNP and peak oxygen uptake (VO 2peak ), assessed at baseline, post-intervention, and at 1- and 2-years. Results For this per-protocol analysis, 88 women met criteria for inclusion. Plasma cTnT increased in all groups post-intervention. At the 1-year follow-up, Nt-pro-BNP was lower in the exercise groups compared to UC. At 2-years there was a drop in VO 2peak for patients with high cTnT and Nt-pro-BNP. Fewer patients in the RT-HIIT group fulfilled biomarker risk criteria compared to UC (OR 0.200; 95% CI = 0.055–0.734). Conclusions In this cohort, high-intensity exercise was associated with lower levels of NT-proBNP 1-year post-baseline, but not with cTnT directly after treatment completion. This may, together with the preserved VO 2peak in patients with low levels of biomarkers, indicate a long-term cardioprotective effect of exercise. Trial registration Clinicaltrials.govNCT02522260, Registered 13th of august 2015 – Retrospectively Registered Graphical abstract
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Ansund et al. (2021) conducted an RCT in Breast Cancer (n=88). Resistance and high-intensity interval training (RT-HIIT) vs. Usual care was evaluated on Fulfillment of biomarker risk criteria for decreased cardiac function (cTnT > 10 ng/ml post-intervention and Nt-pro-BNP > 100 ng/ml at 1-year) (OR 0.200, 95% CI 0.055-0.734, p=0.04). Resistance and high-intensity interval training during breast cancer chemotherapy significantly reduced the odds of fulfilling biomarker risk criteria for decreased cardiac function compared to usual care (OR 0.200).
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