Development of Exercise as Interception Therapy for Cancer: A Review

Iyengar, Neil M.; Jones, Lee W.

doi:10.1001/jamaoncol.2019.2585

Cited by 67Cancer survivorship and carePhysical Activity and HealthCancer Risks and Factors

Development of Exercise as Interception Therapy for Cancer: A Review

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Iyengar, Neil M., Jones, Lee W.·2019·JAMA Oncology

DOI 10.1001/jamaoncol.2019.2585PMC PMC7542631

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Abstract

IMPORTANCE: Observational data linking physical activity and exercise exposure with reduced risk of either development or progression of cancer have fueled interest in the initiation of large-scale definitive trials to test the association of exercise therapy with disease outcomes. However, several major knowledge gaps impede the rational and optimal design of such trials. OBSERVATIONS: Critical requirements underpinning the success of several recent contemporary anticancer agents have included adequate demonstration of antitumor activity (in phase 1/2 trials) as well as identification of essential prerequisites (eg, biologically effective dose and predictors of response) permitting optimal design of definitive trials. The existing evidence base investigating exercise as a candidate anticancer preventive or treatment strategy is predominantly confined to observational data, which have several inherent limitations. Consequently, the antitumor activity of exercise remains unclear and, perhaps more important, such data are not sufficient to accurately derive the exercise dose, prescription regimen, or patients most likely to benefit from exercise. In adherence with translational frameworks for lifestyle therapy development, the need for early phase 1/2-equivalent trials to fill current knowledge gaps to optimize the development and potential efficacy of exercise therapy is highlighted. CONCLUSIONS AND RELEVANCE: Exercise therapy has significant promise to be an efficacious and cost-effective therapy to improve cancer outcomes, with few toxic effects. Although most nontraditional therapies in cancer prevention and prognosis fail in definitive trials, these failures provide critical lessons for the continued development of exercise as a candidate anticancer therapy.

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Exercise dose substantially influences tumor physiology.
“Emerging data suggest that exercise dose plays a significant role in modulating tumor physiology (2,52).”
From Exercise Training Improves Tumor Control by Increasing CD8+ T-cell Infiltration via CXCR3 Signaling and Sensitizes Breast Cancer to Immune Checkpoint Blockade (2021) · cites this paper as [2]
Poor control of exercise dose may explain the wide variability and lack of significant findings in clinical exercise trials.
“More importantly, the lack of proper control of exercise dose might account for the large variability and absence of significant results from exercise interventions in clinical trials (2).”
From Exercise Training Improves Tumor Control by Increasing CD8+ T-cell Infiltration via CXCR3 Signaling and Sensitizes Breast Cancer to Immune Checkpoint Blockade (2021) · cites this paper as [2]

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[43]Jones LW. Precision Oncology Framework for Investigation of Exercise as Treatment for Cancer. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 10 12 2015. PMC4979240 26460301

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Authors: Iyengar, N. M., & Jones, L. W.
Affiliations: Memorial Sloan Kettering Cancer Center (US)
ORCID: Iyengar, Neil M.
Jones, Lee W.
Venue: JAMA Oncology
Publisher: American Medical Association (AMA)
Published: 2019-11-01
Volume: 5
Issue: 11
Pages: 1620
ISSN: 2374-2437 (ISSN-L)
DOI: 10.1001/jamaoncol.2019.2585
PMC: PMC7542631
OpenAlex: W2969458557
Cited by: 67
References: 85
Citations by year: 2026: 5 · 2025: 4 · 2024: 10 · 2023: 6 · 2022: 12 · 2021: 10 · 2020: 16 · 2019: 4
FWCI: 4.39
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: JAMA Oncology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Cancer Institute (P30CA008748)
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Keywords: exercise therapy, cancer prevention, cancer therapy, anticancer activity, translational research, predictors of treatment response

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Development of Exercise as Interception Therapy for Cancer: A Review

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