Targeting Exercise Interventions to Patients With Cancer in Need

An Individual Patient Data Meta-Analysis

Laurien M. Buffart, Maike G. Sweegers, Anne M. May, Mai J. Chinapaw, Jonna K. van Vulpen, Rob U. Newton, Daniel A. Galvão, Neil K. Aaronson, Martijn M. Stuiver, Paul B. Jacobsen, Irma M. Verdonck-de Leeuw, Karen Steindorf, Melinda L. Irwin, Sandi Hayes, Kathleen A. Griffith, Alejandro Lucia, Fernando Herrero-Roman, Ilse Mesters, Ellen van Weert, Hans Knoop & 29 others Martine M. Goedendorp, Nanette Mutrie, Amanda J. Daley, Alex McConnachie, Martin Bohus, Lene Thorsen, Karl Heinz Schulz, Camille E. Short, Erica L. James, Ronald C. Plotnikoff, Gill Arbane, Martina E. Schmidt, Karin Potthoff, Marc van Beurden, Hester S. Oldenburg, Gabe S. Sonke, Wim H. van Harten, Rachel Garrod, Kerri Winters-Stone, Kerri M. Winters-Stone, Miranda J. Velthuis, Dennis R. Taaffe, Willem van Mechelen, Marie José Kersten, Frans Nollet, Jennifer Wenzel, Joachim Wiskemann, Johannes Brug, Kerry S. Courneya

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment. Methods: Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction < .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction < .001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.

Original languageEnglish (US)
Pages (from-to)1190-1200
Number of pages11
JournalJournal of the National Cancer Institute
Volume110
Issue number11
DOIs
StatePublished - Nov 1 2018

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Meta-Analysis
Exercise
Neoplasms
Fatigue
Muscle Strength
Quality of Life
Therapeutics
Costs and Cost Analysis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Buffart, L. M., Sweegers, M. G., May, A. M., Chinapaw, M. J., van Vulpen, J. K., Newton, R. U., ... Courneya, K. S. (2018). Targeting Exercise Interventions to Patients With Cancer in Need: An Individual Patient Data Meta-Analysis. Journal of the National Cancer Institute, 110(11), 1190-1200. https://doi.org/10.1093/jnci/djy161

Targeting Exercise Interventions to Patients With Cancer in Need : An Individual Patient Data Meta-Analysis. / Buffart, Laurien M.; Sweegers, Maike G.; May, Anne M.; Chinapaw, Mai J.; van Vulpen, Jonna K.; Newton, Rob U.; Galvão, Daniel A.; Aaronson, Neil K.; Stuiver, Martijn M.; Jacobsen, Paul B.; Verdonck-de Leeuw, Irma M.; Steindorf, Karen; Irwin, Melinda L.; Hayes, Sandi; Griffith, Kathleen A.; Lucia, Alejandro; Herrero-Roman, Fernando; Mesters, Ilse; van Weert, Ellen; Knoop, Hans; Goedendorp, Martine M.; Mutrie, Nanette; Daley, Amanda J.; McConnachie, Alex; Bohus, Martin; Thorsen, Lene; Schulz, Karl Heinz; Short, Camille E.; James, Erica L.; Plotnikoff, Ronald C.; Arbane, Gill; Schmidt, Martina E.; Potthoff, Karin; van Beurden, Marc; Oldenburg, Hester S.; Sonke, Gabe S.; van Harten, Wim H.; Garrod, Rachel; Winters-Stone, Kerri; Winters-Stone, Kerri M.; Velthuis, Miranda J.; Taaffe, Dennis R.; van Mechelen, Willem; José Kersten, Marie; Nollet, Frans; Wenzel, Jennifer; Wiskemann, Joachim; Brug, Johannes; Courneya, Kerry S.

In: Journal of the National Cancer Institute, Vol. 110, No. 11, 01.11.2018, p. 1190-1200.

Research output: Contribution to journalArticle

Buffart, LM, Sweegers, MG, May, AM, Chinapaw, MJ, van Vulpen, JK, Newton, RU, Galvão, DA, Aaronson, NK, Stuiver, MM, Jacobsen, PB, Verdonck-de Leeuw, IM, Steindorf, K, Irwin, ML, Hayes, S, Griffith, KA, Lucia, A, Herrero-Roman, F, Mesters, I, van Weert, E, Knoop, H, Goedendorp, MM, Mutrie, N, Daley, AJ, McConnachie, A, Bohus, M, Thorsen, L, Schulz, KH, Short, CE, James, EL, Plotnikoff, RC, Arbane, G, Schmidt, ME, Potthoff, K, van Beurden, M, Oldenburg, HS, Sonke, GS, van Harten, WH, Garrod, R, Winters-Stone, K, Winters-Stone, KM, Velthuis, MJ, Taaffe, DR, van Mechelen, W, José Kersten, M, Nollet, F, Wenzel, J, Wiskemann, J, Brug, J & Courneya, KS 2018, 'Targeting Exercise Interventions to Patients With Cancer in Need: An Individual Patient Data Meta-Analysis', Journal of the National Cancer Institute, vol. 110, no. 11, pp. 1190-1200. https://doi.org/10.1093/jnci/djy161
Buffart, Laurien M. ; Sweegers, Maike G. ; May, Anne M. ; Chinapaw, Mai J. ; van Vulpen, Jonna K. ; Newton, Rob U. ; Galvão, Daniel A. ; Aaronson, Neil K. ; Stuiver, Martijn M. ; Jacobsen, Paul B. ; Verdonck-de Leeuw, Irma M. ; Steindorf, Karen ; Irwin, Melinda L. ; Hayes, Sandi ; Griffith, Kathleen A. ; Lucia, Alejandro ; Herrero-Roman, Fernando ; Mesters, Ilse ; van Weert, Ellen ; Knoop, Hans ; Goedendorp, Martine M. ; Mutrie, Nanette ; Daley, Amanda J. ; McConnachie, Alex ; Bohus, Martin ; Thorsen, Lene ; Schulz, Karl Heinz ; Short, Camille E. ; James, Erica L. ; Plotnikoff, Ronald C. ; Arbane, Gill ; Schmidt, Martina E. ; Potthoff, Karin ; van Beurden, Marc ; Oldenburg, Hester S. ; Sonke, Gabe S. ; van Harten, Wim H. ; Garrod, Rachel ; Winters-Stone, Kerri ; Winters-Stone, Kerri M. ; Velthuis, Miranda J. ; Taaffe, Dennis R. ; van Mechelen, Willem ; José Kersten, Marie ; Nollet, Frans ; Wenzel, Jennifer ; Wiskemann, Joachim ; Brug, Johannes ; Courneya, Kerry S. / Targeting Exercise Interventions to Patients With Cancer in Need : An Individual Patient Data Meta-Analysis. In: Journal of the National Cancer Institute. 2018 ; Vol. 110, No. 11. pp. 1190-1200.
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abstract = "Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment. Methods: Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction < .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction < .001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.",
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TY - JOUR

T1 - Targeting Exercise Interventions to Patients With Cancer in Need

T2 - An Individual Patient Data Meta-Analysis

AU - Buffart, Laurien M.

AU - Sweegers, Maike G.

AU - May, Anne M.

AU - Chinapaw, Mai J.

AU - van Vulpen, Jonna K.

AU - Newton, Rob U.

AU - Galvão, Daniel A.

AU - Aaronson, Neil K.

AU - Stuiver, Martijn M.

AU - Jacobsen, Paul B.

AU - Verdonck-de Leeuw, Irma M.

AU - Steindorf, Karen

AU - Irwin, Melinda L.

AU - Hayes, Sandi

AU - Griffith, Kathleen A.

AU - Lucia, Alejandro

AU - Herrero-Roman, Fernando

AU - Mesters, Ilse

AU - van Weert, Ellen

AU - Knoop, Hans

AU - Goedendorp, Martine M.

AU - Mutrie, Nanette

AU - Daley, Amanda J.

AU - McConnachie, Alex

AU - Bohus, Martin

AU - Thorsen, Lene

AU - Schulz, Karl Heinz

AU - Short, Camille E.

AU - James, Erica L.

AU - Plotnikoff, Ronald C.

AU - Arbane, Gill

AU - Schmidt, Martina E.

AU - Potthoff, Karin

AU - van Beurden, Marc

AU - Oldenburg, Hester S.

AU - Sonke, Gabe S.

AU - van Harten, Wim H.

AU - Garrod, Rachel

AU - Winters-Stone, Kerri

AU - Winters-Stone, Kerri M.

AU - Velthuis, Miranda J.

AU - Taaffe, Dennis R.

AU - van Mechelen, Willem

AU - José Kersten, Marie

AU - Nollet, Frans

AU - Wenzel, Jennifer

AU - Wiskemann, Joachim

AU - Brug, Johannes

AU - Courneya, Kerry S.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment. Methods: Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction < .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction < .001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.

AB - Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment. Methods: Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction < .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction < .001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.

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