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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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“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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Self-citationTan–Allen, K., Chin-Sinex, H., DeLuca, T., Pomerening, J. R., Sherer, J., Watkins, J. B., Foley, J., Jesseph, J. M., & Mendonca, M. S. (2015) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2015.08.006 · Cited by 42
Targeting glycolysis by 3-bromopyruvate improves tamoxifen cytotoxicity of breast cancer cell lines
Attia, Y. M., El-Abhar, H. S., Marzabani, M. M. A., & Shouman, S. A. (2015) · BMC Cancer · doi:10.1186/s12885-015-1850-4 · Cited by 41
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Hypoxia enhances indoleamine 2,3-dioxygenase production in dendritic cells
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Reprogramming of tumor metabolism by targeting mitochondria improves tumor response to irradiation
Bol, V., Bol, A., Bouzin, C., Labar, D., Lee, J. A., Janssens, G., Porporato, P. E., Sonveaux, P., Féron, O., & Grégoire, V. (2014) · Acta Oncologica · doi:10.3109/0284186x.2014.932006 · Cited by 35
Voluntary exercise slows breast tumor establishment and reduces tumor hypoxia in ApoE−/− mice
Buss, L. A., & Dachs, G. U. (2018) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00738.2017 · Cited by 32
Strömberg, A., Rullman, E., Jansson, E., & Gustafsson, T. P. (2017) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00956.2016 · Cited by 28
Marathon Race Affects Neutrophil Surface Molecules: Role of Inflammatory Mediators
Santos, V. C., Sierra, A., de Oliveira, R. A., Caçula, K. G., Momesso, C. M., Sato, F. T., Silva, M. B. B., de Oliveira, H. H., Passos, M. E. P., de Souza, D. R., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0166687 · Cited by 26
Motility of IL-2-stimulated lymphocytes in neutral and acidified extracellular matrix
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Structural, Contractile and Electrophysiological Adaptations of Cardiomyocytes to Chronic Exercise
Krzesiak, A., Delpech, N., Sebille, S., Cognard, C., & Chatelier, A. (2017) · Advances in experimental medicine and biology · doi:10.1007/978-981-10-4307-9_5 · Cited by 7
Flagged first, then by citations
2 of the 108 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Lu M., Sanderson S.M., Zessin A.S., et al: Manuscript under review.
Cited by
Sorted by citations
Gomes-Santos, I. L., Amoozgar, Z., Kumar, A. S., Ho, W. W., Roh, K., Talele, N. P., Curtis, H., Kawaguchi, K., Jain, R. K., & Fukumura, D. (2021) · Cancer Immunology Research · doi:10.1158/2326-6066.cir-20-0499 · Cited by 181
Exercise and the immune system: taking steps to improve responses to cancer immunotherapy
Gustafson, M. P., Wheatley, C. M., Rosenthal, A. C., Gastineau, D. A., Katsanis, E., Johnson, B. D., & Simpson, R. J. (2021) · Journal for ImmunoTherapy of Cancer · doi:10.1136/jitc-2020-001872 · Cited by 166
Circadian rhythms and cancers: the intrinsic links and therapeutic potentials
Zhou, L., Zhang, Z., Nice, E. C., Huang, C., Zhang, W., & Tang, Y. C. (2022) · Journal of Hematology & Oncology · doi:10.1186/s13045-022-01238-y · Cited by 163
Donoso, F., Cryan, J. F., Olavarría‐Ramírez, L., Nolan, Y. M., & Clarke, G. A. (2022) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.2581 · Cited by 155
Intestinal Microbiota: A Novel Target to Improve Anti-Tumor Treatment?
Villéger, R., Lopès, A., Carrier, G., Véziant, J., Billard, E., Barnich, N., Gagnière, J., Vazeille, E., & Bonnet, M. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20184584 · Cited by 125
Metadata
- 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
- 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 › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Physiology (medical) › 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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