Physical Activity Associated With Improved PFS, OS in Advanced CRC

Among patients with advanced colorectal cancer, greater total physical activity improved progression-free and overall survival, while greater walking and non-vigorous physical activity reduced the risk of all-cause mortality, according to a study being presented at the 2017 Gastrointestinal Cancers Symposium.¹

To evaluate the effect of regular physical activity on outcomes for patients with mCRC, researchers surveyed 1231 patients enrolled in the phase 3 CALGB 80405 trial of first-line chemoimmunotherapy in mCRC (ClinicalTrials.gov Identifier: NCT00265850) about physical activity at the time of chemotherapy initiation.

Patients who engaged in 18 or more metabolic equivalent task (MET)-hours per week (equivalent to 30 or more minutes each day of moderate physical activity such as walking, cleaning, or gardening), were considered physically active. Researchers classified those engaging in fewer than 3 MET-hours per week (equivalent to 30 minutes of physical activity per day), as insufficiently active.

Physically active patients had a 19% reduced risk of death (hazard ratio [HR], 0.81; 95% CI, 0.67-0.98; P_trend = .03) and a 16% reduced risk of progression or death (HR, 0.84; 95% CI, 0.71-1.00; P_trend = .03).

Greater non-vigorous physical activity and walking were both associated with improved overall survival, though there was no association between vigorous physical activity—such as running and playing sports—and clinical outcomes.

“These findings suggest that it doesn’t take a lot of physical activity to improve outcomes,” lead investigator Brendan John Guercio, MD, a resident physician at Brigham & Women’s Hospital in Boston, Massachusetts, said in a press release. “While exercise is by no means a substitute for chemotherapy, patients can experience a wide range of benefits from as little as 30 minutes of exercise a day.”

Randomized controlled trials and additional prospective clinical studies are necessary to validate the associations between physical activity and outcomes in this population. An ongoing randomized clinical trial is comparing outcomes of patients who exercise during therapy with those who do not.

Reference

1. Guercio BJ, Venook AP, Niedzwiecki D, et al. Associations of physical activity with survival and progression in metastatic colorectal cancer: Results from CALGB 80405 (Alliance). J Clin Oncol. 2017;35(suppl):4S. Abstract 659.