| Current evidence |
Observational data support an association between higher physical activity levels and lower risk of several cancers including colon, breast, kidney, endometrial, bladder, esophagus (adenocarcinoma), gastric (cardia), and lung. Observational data support an association between increased post-diagnosis physical activity and lower disease-specific mortality for breast, colon, and prostate cancers. Limited preclinical data support antitumor activity of exercise in murine or human models of cancer. Data from RCTs support a benefit of exercise on patient reported outcomes and symptom control endpoints in cancer populations. |
| Limitations |
Physical activity only assessed by self-report at a single time-point in observational studies. A broad range of physical activity / exercise ‘doses’ associated witd reductions in primary cancer risk or cancer-related mortality. Biological activity (e.g., effects on tumor or tumor microenvironment) not known. Predictors of response (e.g., clinicopatdologic features, tumor subtype, genomic signatures) not known. |
| Future directions |
Preclinical or “co-clinical” testing demonstrating modulation of tissue and tumor markers in relevant animal models Conduct of early phase dose-finding / dose-escalation trials to identify feasible doses of exercise in the target population and setting (i.e., phase 1a) Correlative science studies to examine biological activity of the identified feasible exercise doses. Confirmation of feasibility and evaluation of preliminary antitumor efficacy in safety / dose-expansion (phase 1b) testing. Determination of the recommended phase 2 dose based on feasibility and biological activity. |
