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Liu J, Liu W, Wan Y, Mao W. Crosstalk between Exercise and Immunotherapy: Current Understanding and Future Directions. RESEARCH (WASHINGTON, D.C.) 2024; 7:0360. [PMID: 38665847 PMCID: PMC11045263 DOI: 10.34133/research.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
Accumulated evidence highlights that exercise can modulate multiple cytokines, influencing transcriptional pathways, and reprogramming certain metabolic processes, ultimately promoting antitumor immunity and enhancing the efficacy of immune checkpoint inhibitors in cancer patients. Exploring the mechanisms behind this will, for one thing, help us uncover key factors and pathways in exercise-assisted cancer immunotherapy, offering more possibilities for future treatment methods. For another, it will support the development of more personalized and effective exercise prescriptions, thereby improving the prognosis of cancer patients.
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Affiliation(s)
- Jiwei Liu
- Department of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center,
Nanjing Medical University, Wuxi 214023, China
- Wuxi College of Clinical Medicine,
Nanjing Medical University, Wuxi 214023, China
| | - Weici Liu
- Department of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center,
Nanjing Medical University, Wuxi 214023, China
- Wuxi College of Clinical Medicine,
Nanjing Medical University, Wuxi 214023, China
| | - Yuan Wan
- The Pq Laboratory of BiomeDx/Rx, Department of Biomedical Engineering,
Binghamton University, Binghamton, NY 13850, USA
| | - Wenjun Mao
- Department of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center,
Nanjing Medical University, Wuxi 214023, China
- Wuxi College of Clinical Medicine,
Nanjing Medical University, Wuxi 214023, China
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2
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Smith GVH, Myers SA, Fujita RA, Yu C, Campbell KL. Virtually Supervised Exercise Programs for People With Cancer: A Scoping Review. Cancer Nurs 2024:00002820-990000000-00236. [PMID: 38598778 DOI: 10.1097/ncc.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Exercise has been shown to improve physical function and quality of life for individuals with cancer. However, low rates of exercise adoption and commonly reported barriers to accessing exercise programming have demonstrated a need for virtual exercise programming in lieu of traditional in-person formats. OBJECTIVE The aim of this study was to summarize the existing research on supervised exercise interventions delivered virtually for individuals living with and beyond cancer. METHODS We conducted a scoping review of randomized controlled trials, pilot studies, or feasibility studies investigating virtually supervised exercise interventions for adults either during or after treatment of cancer. The search included EMBASE, MEDLINE, CINAHL, SPORTDiscus, Cochrane Library, and conference abstracts. RESULTS Fifteen studies were included. The interventions were delivered mostly over Zoom in a group format, with various combinations of aerobic and resistance exercises. Attendance ranged from 78% to 100%, attrition ranged from 0% to 29%, and satisfaction ranged from 94% to 100%. No major adverse events were reported, and only 3 studies reported minor adverse events. Significant improvements were seen in upper and lower body strength, endurance, pain, fatigue, and emotional well-being. CONCLUSION Supervised exercise interventions delivered virtually are feasible and may improve physical function for individuals with cancer. The supervision included in these virtual programs promoted similar safety as seen with in-person programming. More randomized controlled trials with large cohorts are needed to validate these findings. IMPLICATIONS FOR PRACTICE Individuals living with and beyond cancer can be encouraged to join virtually supervised exercise programs because they are safe, well enjoyed, and may improve physical function and quality of life.
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Affiliation(s)
- Gillian V H Smith
- Author Affiliations: Department of Physical Therapy, University of British Columbia (Mss Smith, Myers, and Yu; Mr Fujita; and Dr Campbell), Vancouver, Canada; and University of São Paulo (Mr Fujita), Brazil
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Aromatario O, Cambon L, Alla F, Imbert A, Pouchepadass C, Renvoisé N, Dauchy S, Charles C. Conditions for adherence to videoconference-based programs promoting adapted physical activity in cancer patients: a realist evaluation. Implement Sci 2024; 19:6. [PMID: 38287336 PMCID: PMC10823602 DOI: 10.1186/s13012-024-01338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Although moderate physical activity (PA) during cancer treatment has been associated with improved quality of life, reduced side effects, and even lower mortality, many barriers to successful implementation remain. Digital technology has been perceived as an effective lever for overcoming access and motivational issues but few studies have been performed to confirm this assumption. The "VISIO-AJUST" study explored the factors affecting the conditions of adherence to video-conference-based PA programs in patients undergoing cancer treatment. METHODS The VISIO-AJUST study was based on a qualitative successive case approach, guided by the principles of the realist evaluation, and applied to two French programs of PA, following three main steps: (1) Identification of factors likely to influence conditions of patients' adherence; (2) Elaboration and testing of explanatory "Context-Mechanism-Outcome (CMO)" configurations; (3) Refinement of CMO configurations, in order to understand what, how, for whom, and under what circumstances video-conference-based PA programs work. RESULTS Five main CMO configurations were found to be associated with adherence to video-conferencing-based PA programs, promoting (i) accessibility and a supportive environment for adapted physical activity, (ii) a setting conducive to sociability despite distance, (iii) Confidence and security of practice, (iv) a combination of several motivational levers in favor of continuity of effort and progress, (v) regularity of the sessions, progressiveness in the effort and evaluation of progress as a basis for the adoption of a regular physical practice. CONCLUSION This study provides original insights into the use of videoconferencing to enable patients to improve their PA during cancer treatment. Future research with long-term follow-up would allow for a better understanding of the key conditions promoting sustainable behavior change.
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Affiliation(s)
- Olivier Aromatario
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France.
| | - Linda Cambon
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France
| | - François Alla
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France
| | | | | | | | | | - Cécile Charles
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France
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Escriva-Boulley G, Philip CA, Warembourg S, Lenotre L, Flore P, Faure P, Michy T, Letouzey V, Arnold C, Piluso C, Chalmel L, Kacem R, Blum GF, Detayrac R, Trocmé C, Brigaud I, Herbach U, Branche P, Faller E, Chalabaev A. Effects of a physical activity and endometriosis-based education program delivered by videoconference on endometriosis symptoms: the CRESCENDO program (inCRease physical Exercise and Sport to Combat ENDOmetriosis) protocol study. Trials 2023; 24:759. [PMID: 38012776 PMCID: PMC10680283 DOI: 10.1186/s13063-023-07792-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Endometriosis is a chronic disease characterized by growth of endometrial tissue outside the uterine cavity which could affect 200 million women (The term "woman" is used for convenience. Individuals gendered as man or as nonbinary can also suffer from this disease) worldwide. One of the most common symptoms of endometriosis is pelvic chronic pain associated with fatigue. This pain can cause psychological distress and interpersonal difficulties. As for several chronic diseases, adapted physical activity could help to manage the physical and psychological symptoms. The present study will investigate the effects of a videoconference-based adapted physical activity combined with endometriosis-based education program on quality of life, pain, fatigue, and other psychological symptoms and on physical activity. METHODS This multicentric randomized-controlled trial will propose to 200 patients with endometriosis to be part of a trial which includes a 6-month program with 45 min to more than 120 min a week of adapted physical activity and/or 12 sessions of endometriosis-based education program. Effects of the program will be compared to a control group in which patients will be placed on a waiting list. All participants will be followed up 3 and 6 months after the intervention. None of the participants will be blind to the allocated trial arm. The primary outcome measure will be quality of life. Secondary outcomes will include endometriosis-related perceived pain, fatigue, physical activity, and also self-image, stereotypes, motivational variables, perceived support, kinesiophobia, basic psychological need related to physical activity, and physical activity barriers. General linear models and multilevel models will be performed. Predictor, moderator, and mediator variables will be investigated. DISCUSSION This study is one of the first trials to test the effects of a combined adapted physical activity and education program for improving endometriosis symptoms and physical activity. The results will help to improve care for patients with endometriosis. TRIAL REGISTRATION ClinicalTrials.gov, NCT05831735 . Date of registration: April 25, 2023.
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Affiliation(s)
- Géraldine Escriva-Boulley
- Université de Haute-Alsace, Université de Strasbourg, Université de Lorraine, LISEC UR 2310, F-68100, Mulhouse, France.
| | - Charles-André Philip
- Clinique gynécologique et obstétricale, Hôpital de la Croix-Rousse, groupe hospitalier Nord, CHU de Lyon-HCL, 103, grande rue de la Croix-Rousse, 69317, Lyon cedex, France
| | - Sophie Warembourg
- Clinique gynécologique et obstétricale, Hôpital de la Croix-Rousse, groupe hospitalier Nord, CHU de Lyon-HCL, 103, grande rue de la Croix-Rousse, 69317, Lyon cedex, France
| | - Lionel Lenotre
- Faculté des Sciences et Techniques, Université de Haute-Alsace, 18 Rue des Frères Lumière, 68200, Mulhouse, France
- PASTA - Processus aléatoires spatio-temporels et leurs applications, Inria Nancy - Grand Est, Villers-lès-, Nancy, France
| | - Patrice Flore
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, HP2, 38000, Grenoble, France
| | - Patrice Faure
- Grenoble University Hospital, Avenue Maquis du Grésivaudan, 38700, La Tronche, France
| | - Thierry Michy
- Department of Gynecology, Grenoble University Hospital, Avenue Maquis du Grésivaudan, 38700, La Tronche, France
| | | | - Carole Arnold
- Université de Lorraine, Inserm, UMRS 1256, NGERE - Nutrition, Genetics, and Environmental Risk Exposure, F-54000, Nancy, France
| | - Claire Piluso
- Université de Haute-Alsace, Université de Strasbourg, SAGE, F-68100, Mulhouse, France
| | - Loic Chalmel
- Université de Haute-Alsace, Université de Strasbourg, Université de Lorraine, LISEC UR 2310, F-68100, Mulhouse, France
| | - Ramzi Kacem
- Service gynécologie GHRMSA, Hôpital Emile Muller, Mulhouse, France
| | - Georges Fabrice Blum
- Cabinet Médical, Clinique du Diaconat-Fonderie et Université de Haute-Alsace, Mulhouse, France
| | | | - Candice Trocmé
- Grenoble University Hospital, Avenue Maquis du Grésivaudan, 38700, La Tronche, France
| | - Isabelle Brigaud
- Université de Haute-Alsace, CNRS, IS2M UMR 7361, Mulhouse, France
| | - Ulysse Herbach
- Université de Lorraine, CNRS, Inria, IECL, F-54000, Nancy, France
| | - Patricia Branche
- Service d'Anesthésie Réanimation Chirurgicale, Hospices Civils de Lyon, Groupement Hospitalier Nord Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, F-69317, Lyon, France
| | - Emilie Faller
- Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, 67200, Strasbourg, France
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Brummer C, Pukrop T, Wiskemann J, Bruss C, Ugele I, Renner K. Can Exercise Enhance the Efficacy of Checkpoint Inhibition by Modulating Anti-Tumor Immunity? Cancers (Basel) 2023; 15:4668. [PMID: 37760634 PMCID: PMC10526963 DOI: 10.3390/cancers15184668] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
Immune checkpoint inhibition (ICI) has revolutionized cancer therapy. However, response to ICI is often limited to selected subsets of patients or not durable. Tumors that are non-responsive to checkpoint inhibition are characterized by low anti-tumoral immune cell infiltration and a highly immunosuppressive tumor microenvironment. Exercise is known to promote immune cell circulation and improve immunosurveillance. Results of recent studies indicate that physical activity can induce mobilization and redistribution of immune cells towards the tumor microenvironment (TME) and therefore enhance anti-tumor immunity. This suggests a favorable impact of exercise on the efficacy of ICI. Our review delivers insight into possible molecular mechanisms of the crosstalk between muscle, tumor, and immune cells. It summarizes current data on exercise-induced effects on anti-tumor immunity and ICI in mice and men. We consider preclinical and clinical study design challenges and discuss the role of cancer type, exercise frequency, intensity, time, and type (FITT) and immune sensitivity as critical factors for exercise-induced impact on cancer immunosurveillance.
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Affiliation(s)
- Christina Brummer
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053 Regensburg, Germany;
- Comprehensive Cancer Center Ostbayern (CCCO), 93053 Regensburg, Germany
| | - Tobias Pukrop
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053 Regensburg, Germany;
- Comprehensive Cancer Center Ostbayern (CCCO), 93053 Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), 93053 Regensburg, Germany
| | - Joachim Wiskemann
- National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany;
| | - Christina Bruss
- Department of Gynecology and Obstetrics, University Medical Center Regensburg, 93053 Regensburg, Germany;
| | - Ines Ugele
- Department of Otorhinolaryngology, University Hospital Regensburg, 93053 Regensburg, Germany; (I.U.); (K.R.)
| | - Kathrin Renner
- Comprehensive Cancer Center Ostbayern (CCCO), 93053 Regensburg, Germany
- Department of Otorhinolaryngology, University Hospital Regensburg, 93053 Regensburg, Germany; (I.U.); (K.R.)
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Hübner J, Rudolph I, Wozniak T, Pietsch R, Margolina M, Garcia I, Mayr-Welschlau K, Schmidt T, Keinki C. Evaluation of a Virtual Dance Class for Cancer Patients and Their Partners during the Corona Pandemic-A Real-World Observational Study. Curr Oncol 2023; 30:4427-4436. [PMID: 37232795 DOI: 10.3390/curroncol30050337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/11/2023] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND During the corona pandemic, all courses on physical activity for cancer patients were canceled. The aim of our study was to evaluate the feasibility of switching dancing classes for patients and their partners to online classes. METHODS Patients and partners from courses at four different locations who consented to the online course offer were asked to fill in a pseudonymous questionnaire on access to the training, technical challenges, acceptance and well-being (1-item visual analog scale from 1 to 10) before and after the training. RESULTS Sixty-five participants returned the questionnaire (39 patients and 23 partners). Fifty-eight (89.2%) had danced before, and forty-eight (73.8%) had visited at least one course of ballroom dancing for cancer patients before. The first access to the online platform was difficult for 39 participants (60%). Most participants (57; 87.7%) enjoyed the online classes, but 53 (81.5%) rated them as less fun than the real classes as direct contact was missing. Well-being increased significantly after the lesson and remained improved for several days. CONCLUSION Transforming a dancing class is feasible for participants with digital experience and goes along with technical difficulties. It is a substitute for real classes if mandatory and improves well-being.
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Affiliation(s)
- Jutta Hübner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Ivonne Rudolph
- Waldburg-Zeil Kliniken, Rehabilitationsklinik Bad Salzelmen, Badepark 5, 39218 Schönebeck, Germany
| | - Tobias Wozniak
- Working Group Prevention and Integrative Oncology, German Cancer Society, Kuno-Fischer-Str. 8, 14057 Berlin, Germany
| | - Ronny Pietsch
- Working Group Prevention and Integrative Oncology, German Cancer Society, Kuno-Fischer-Str. 8, 14057 Berlin, Germany
| | - Mascha Margolina
- Working Group Prevention and Integrative Oncology, German Cancer Society, Kuno-Fischer-Str. 8, 14057 Berlin, Germany
| | - Isabel Garcia
- Working Group Prevention and Integrative Oncology, German Cancer Society, Kuno-Fischer-Str. 8, 14057 Berlin, Germany
| | - Katharina Mayr-Welschlau
- Working Group Prevention and Integrative Oncology, German Cancer Society, Kuno-Fischer-Str. 8, 14057 Berlin, Germany
| | - Thorsten Schmidt
- Cancer Center North, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Christian Keinki
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany
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Handford J, Chen M, Rai R, Moss CL, Enting D, Peat N, Karagiannis SN, Van Hemelrijck M, Russell B. Is There a Role for Exercise When Treating Patients with Cancer with Immune Checkpoint Inhibitors? A Scoping Review. Cancers (Basel) 2022; 14:cancers14205039. [PMID: 36291823 PMCID: PMC9599872 DOI: 10.3390/cancers14205039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022] Open
Abstract
The impact of using exercise as a non-pharmacological intervention in patients with cancer receiving immune checkpoint inhibitors (ICIs) is not well known. Our objective was to determine the extent of, and identify gaps within, available literature addressing the effect of exercise on (a) oncological outcomes and (b) quality of life (QoL) in patients with cancer receiving ICIs, and (c) the underlying biological mechanisms for such effects. We conducted searches across EMBASE, APA PsycInfo and Ovid MEDLINE(R). Studies were eligible if they addressed at least one aspect of the objective and were available in the English language. Results were synthesised using a narrative approach and subsequently discussed with multidisciplinary stakeholders. As of the final search on 5 April 2022, 11 eligible studies were identified, of which 8 were preclinical and 3 were clinical. Clinical studies only focused on QoL-related outcomes. When studies were grouped by whether they addressed oncological outcomes (n = 7), QoL (n = 5) or biological mechanisms (n = 7), they were found to be heterogeneous in methodology and findings. Additional evidence, particularly in the clinical setting, is required before robust recommendations about whether, and how, to include exercise alongside ICI treatment can be made.
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Affiliation(s)
- Jasmine Handford
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
- Correspondence:
| | - Miaoqi Chen
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Ridesh Rai
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Charlotte L. Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Deborah Enting
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Nicola Peat
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Sophia N. Karagiannis
- St John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
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