Efficacy and Mechanisms of Aerobic Exercise on Cancer Initiation, Progression, and Metastasis: A Critical Systematic Review of In Vivo Preclinical Data
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Abstract
A major objective of the emerging field of exercise–oncology research is to determine the efficacy of, and biological mechanisms by which, aerobic exercise affects cancer incidence, progression, and/or metastasis. There is a strong inverse association between self-reported exercise and the primary incidence of several forms of cancer; similarly, emerging data suggest that exercise exposure after a cancer diagnosis may improve outcomes for early-stage breast, colorectal, or prostate cancer. Arguably, critical next steps in the development of exercise as a candidate treatment in cancer control require preclinical studies to validate the biological efficacy of exercise, identify the optimal “dose”, and pinpoint mechanisms of action. To evaluate the current evidence base, we conducted a critical systematic review of in vivo studies investigating the effects of exercise in cancer prevention and progression. Studies were evaluated on the basis of tumor outcomes (e.g., incidence, growth, latency, metastasis), dose–response, and mechanisms of action, when available. A total of 53 studies were identified and evaluated on tumor incidence (n = 24), tumor growth (n = 33), or metastasis (n = 10). We report that the current evidence base is plagued by considerable methodologic heterogeneity in all aspects of study design, endpoints, and efficacy. Such heterogeneity precludes meaningful comparisons and conclusions at present. To this end, we provide a framework of methodologic and data reporting standards to strengthen the field to guide the conduct of high-quality studies required to inform translational, mechanism-driven clinical trials. Cancer Res; 76(14); 4032–50. ©2016 AACR.
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- Authors
- Ashcraft, K. A., Peace, R. M., Betof, A. S., Dewhirst, M. W., & Jones, L. W.
- Affiliations
- Duke University (US)
- 2Massachusetts General Hospital, Boston, Massachusetts.
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Dewhirst, Mark W.
- Jones, Lee W.
- Venue
- Cancer Research
- Published
- 2016-07-14
- Volume
- 76
- Issue
- 14
- Pages
- 4032-4050
- ISSN
- 0008-5472 (ISSN-L)
- 1538-7445
- PMC
- PMC5378389
- OpenAlex
- W2473034500
- Cited by
- 217
- References
- 109
- Citations by year
- 2026: 18 · 2025: 27 · 2024: 21 · 2023: 12 · 2022: 28 · 2021: 29 · 2020: 30 · 2019: 19 · 2018: 19 · 2017: 12 · 2016: 2
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute AKTIV Against Cancer, and the Memorial Sloan Kettering Cancer Center (P30 CA008748)
- NIH (CA40355)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- aerobic exercise, exercise oncology, cancer prevention, tumor progression, metastasis, tumor growth, tumor latency, exercise dose-response, mechanism of action, preclinical animal models, reporting guidelines
- MeSH terms
- Humans, Neoplasm Metastasis, Neoplasms, Exercise, Disease Progression, Tumor Microenvironment
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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