Exercise-based cardio-oncology rehabilitation for cardiotoxicity prevention during breast cancer chemotherapy: the ONCORE randomized controlled trial
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Exercise-based cardio-oncology rehabilitation for cardiotoxicity prevention during breast cancer chemotherapy: the ONCORE randomized controlled trialAuthor(s)
Date
2024-02-21Citation
Díaz-Balboa E, Peña-Gil C, Rodríguez-Romero B, Cuesta-Vargas AI, Lado-Baleato O, Martínez-Monzonís A, Pedreira-Pérez M, Palacios-Ozores P, López-López R, González-Juanatey JR, González-Salvado V. Exercise-based cardio-oncology rehabilitation for cardiotoxicity prevention during breast cancer chemotherapy: the ONCORE randomized controlled trial. Prog Cardiovasc Dis. 2024 Feb 21:S0033-0620(24)00023-9.
Abstract
[Abstract]
Background: Breast cancer (BC) treatment with anthracyclines and/or anti-human epidermal growth factor receptor-2 (HER2) antibodies is associated with an increased risk of cardiovascular disease complications, including cancer therapy-related cardiac dysfunction (CTRCD). While Cardio-Oncology Rehabilitation (CORe) programs including exercise have emerged to minimize these risks, its role in preventing CTRCD is unclear.
Objectives: We investigated the effectiveness of an exercise-based CORe program in preventing CTRCD [left ventricular ejection fraction (LVEF) drop ≥10% to a value <53% or a decrease >15% in global longitudinal strain (GLS)]. Secondary outcomes examined changes in cardiac biomarkers, physical performance including peak oxygen consumption, psychometric and lifestyle outcomes. Safety, adherence, and patient satisfaction were also assessed.
Methods: This is a randomized controlled trial including 122 early-stage BC women receiving anthracyclines and/or anti-HER2 antibodies, randomized to CORe (n = 60) or usual care with exercise recommendation (n = 62). Comprehensive assessments were performed at baseline and after cardiotoxic treatment completion. The average duration of the intervention was 5.8 months.
Results: No cases of CTRCD were identified during the study. LVEF decreased in both groups, but was significantly attenuated in the CORe group [-1.5% (-2.9, -0.1); p = 0.006], with no changes detected in GLS or cardiac biomarkers. The CORe intervention led to significant body mass index (BMI) reduction (p = 0.037), especially in obese patients [3.1 kg/m2 (1.3, 4.8)]. Physical performance and quality-of-life remained stable, while physical activity level increased in both groups. No adverse events were detected.
Conclusions: This study suggests that CORe programs are safe and may help attenuate LVEF decline in BC women receiving cardiotoxic therapy and reduce BMI in obese patients.
Keywords
Breast cancer
Cardio-oncology rehabilitation
Cardiotoxicity
Cardiovascular prevention
Exercise
Cardio-oncology rehabilitation
Cardiotoxicity
Cardiovascular prevention
Exercise
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Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International Licence (CC BY-NC-ND 4.0)
ISSN
0033-0620