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 trialAutor(es)
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2024-02-21Cita bibliográfica
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.
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[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.
Palabras chave
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