Key result
Exercise training did not significantly improve LVEF overall (MD 2.07%; 95% CI -0.17 to 4.34), but interventions with ≥36 sessions significantly prevented LVEF decline (MD 3.25%; 95% CI 1.20 to 5.31).
Why the study?
To evaluate the efficacy of exercise training on cardiac function and circulating biomarkers outcomes among women with breast cancer receiving anthracycline or trastuzumab-containing therapy.
Does exercise training prevent LVEF decline in women with breast cancer receiving anthracycline or trastuzumab-containing therapy?
Meta-Analysis (n=161)
Does exercise training prevent LVEF decline in women with breast cancer receiving anthracycline or trastuzumab-containing therapy?
Mean Difference: 2.07 (95% CI -0.17–4.34)
Exercise training, particularly when involving 36 or more sessions, may mitigate the decline in left ventricular ejection fraction in women receiving cardiotoxic breast cancer therapies.
Does not support LVEF gains from standard programs; extends evidence favoring intensive regimens to prevent decline.
Background: we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of exercise training on cardiac function and circulating biomarkers outcomes among women with breast cancer (BC) receiving anthracycline or trastuzumab-containing therapy. Methods: PubMed, EMBASE, Cochrane Library, Web of Science and Scopus were searched. The primary outcome was change on left ventricular ejection fraction (LVEF). Secondary outcomes included diastolic function, strain imaging and circulating biomarkers. Results: Four RCTs were included, of those three were conducted during anthracycline and one during trastuzumab, involving 161 patients. All trials provided absolute change in LVEF (%) after a short to medium-term of treatment exposure (≤6 months). Pooled data revealed no differences in LVEF in the exercise group versus control [mean difference (MD): 2.07%; 95% CI: −0.17 to 4.34]. Similar results were observed by pooling data from the three RCTs conducted during anthracycline. Data from trials that implemented interventions with ≥36 exercise sessions (n = 3) showed a significant effect in preventing LVEF decline favoring the exercise (MD: 3.25%; 95% CI: 1.20 to 5.31). No significant changes were observed on secondary outcomes. Conclusions: exercise appears to have a beneficial effect in mitigating LVEF decline and this effect was significant for interventions with ≥36 exercise sessions.
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Antunes et al. (2021) conducted a meta-analysis in Breast cancer receiving anthracycline or trastuzumab-containing therapy (n=161). Exercise training vs. Control was evaluated on Change on left ventricular ejection fraction (LVEF) (MD 2.07%, 95% CI -0.17 to 4.34). Exercise training did not significantly improve LVEF overall (MD 2.07%; 95% CI -0.17 to 4.34), but interventions with ≥36 sessions significantly prevented LVEF decline (MD 3.25%; 95% CI 1.20 to 5.31).
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