Exercise as adjunct therapy in cancer
Open accessAbstract
Data from observational studies indicate that both physical activity as well as exercise (ie, structured physical activity) is associated with reductions in the risk of recurrence and cancer mortality after a diagnosis of certain forms of cancer. Emerging evidence from preclinical studies indicates that physical activity/exercise paradigms regulate intratumoral vascular maturity and perfusion, hypoxia, and metabolism and augments the antitumor immune response. Such responses may, in turn, enhance response to standard anticancer treatments. For instance, exercise improves efficacy of chemotherapeutic agents, and there is rationale to believe that it will also improve radiotherapy response. This review overviews the current preclinical as well as clinical evidence supporting exercise modulation of therapeutic response and postulated biological mechanisms underpinning such effects. We also examine the implications for tumor response to radiation, chemotherapy, and immunotherapy.
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Better tumor blood vessels support adaptive antitumor immunity by helping tumor-infiltrating lymphocytes traffic and relocate, which improves results of immunotherapies such as immune checkpoint blockade.
“An improved vascular network favors adaptive antitumor immunity by promoting trafficking and re-localization of tumor-infiltrating lymphocytes (TILs), leading to improved outcomes of various immunotherapies, including immune checkpoint blockade (ICB) (15-20).”
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- Authors
- Ashcraft, K. A., Warner, A. B., Jones, L. W., & Dewhirst, M. W.
- Affiliations
- Duke University (US)
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Dewhirst, Mark W.
- Venue
- Seminars in Radiation Oncology
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 29
- Issue
- 1
- Pages
- 16-24
- ISSN
- 1053-4296 (ISSN-L)
- PMC
- PMC6656408
- OpenAlex
- W2905164432
- Cited by
- 148
- References
- 108
- Citations by year
- 2026: 14 · 2025: 22 · 2024: 15 · 2023: 19 · 2022: 23 · 2021: 20 · 2020: 25 · 2019: 9 · 2018: 1
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Seminars in Radiation 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 › Rehabilitation › Exercise and Physiological Responses
- Keywords
- physical activity, tumor recurrence, cancer mortality, tumor hypoxia, tumor vascularization, cancer metabolism, antitumor immunity, chemotherapy response, radiotherapy response, immunotherapy response
- MeSH terms
- Antineoplastic Agents, Combined Modality Therapy, Exercise Therapy, Humans, Immunotherapy, Neoplasms, Radiotherapy
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