Real-world feasibility and efficacy of a tailored exercise program in patients with cancer.

Abstract

12040 Background: Exercise (EX) is associated with improved survival, symptom control, and management of treatment-related side effects in patients (pts) with cancer. However, evidence from large, real-world cohorts including unselected pts across different phases of the disease trajectory remains limited. This study aimed to evaluate the feasibility and effectiveness of a tailored EX program implemented in routine clinical practice. Methods: A three-month, bi-weekly supervised EX program was offered to consecutive cancer pts referred at the University Hospital of Verona, regardless of treatment status. The program included moderate-intensity aerobic exercise (10–30 minutes/session) and resistance training (2–3 sets of 8–12 repetitions; six exercises). The primary endpoint was feasibility, assessed by recruitment rate, adherence, and dropout. Secondary endpoints included cardiorespiratory fitness (six-minute walking test, 6MWT), muscular strength (handgrip strength test, HST), waist-hip ratio (WHR), and quality of life (QoL), measured using the EORTC QLQ-C30. Pre- and post-intervention outcomes were analyzed using descriptive statistics and paired Student’s t-tests. Results: A total of 2276pts were recruited (92% recruitment rate) with a median age of 57±12 years. The most frequent tumor types were upper gastrointestinal cancers (34%) and breast cancer (31,8%). 84% of patients were receiving systemic treatments, and 47% had metastatic disease. Overall, 156 pts completed the intervention (dropout rate 31%, mainly due to disease progression), with an adherence rate of 84%. Significant improvements were observed in WHR (−1.2%, p = 0.03), 6MWT (+25 m, p < 0.001), and HST (+1.9 kg, p < 0.01). QoL significantly improved in physical, role, emotional, and social functioning (all p < 0.01), along with reductions in fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, and diarrhea. Global QoL and financial difficulties also significantly improved. Conclusions: In a real-world, unselected cohort of cancer pts across different treatment phases, a tailored EX program is feasible and associated with meaningful improvements in physical function and QoL. These findings support the integration of structured exercise programs into routine oncology care beyond controlled clinical trial settings. Clinical trial information: NCT04226508 .