Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial

Justin C. Brown, Andrea B. Troxel, Bonnie Ky, Nevena Damjanov, Babette S. Zemel, Michael R. Rickels, Andrew D. Rhim, Anil K. Rustgi, Kerry S. Courneya, Kathryn Schmitz

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Postdiagnosis physical activity is associated with a lower risk of disease recurrence among survivors of colon cancer. Thirty-nine stage I to III survivors of colon cancer were randomized to usual-care control, 150 minutes per week, or 300 minutes per week of aerobic exercise for 6 months. Exercise was feasible, well-tolerated, and elicited changes in physiologic markers associated with disease recurrence. This study informs future phase II/III trials. Background: Observational studies suggest that higher volumes of physical activity are associated with a lower risk of disease recurrence among survivors of colon cancer. However, the feasibility and safety of prescribing higher volumes of physical activity to survivors of colon cancer are unknown. Furthermore, the pathways through which exercise may reduce disease recurrence are unknown. Patients and Methods: Survivors of stage I to III colon cancer were randomized to usual-care control, 150 minutes per week of aerobic exercise (low-dose), or 300 minutes per week of aerobic exercise (high-dose). Changes in soluble intercellular adhesion molecule-1 and vascular adhesion molecule-1 prognostic biomarkers were examined. Results: From January 2015 to February 2016, 39 patients were enrolled (n = 13 usual-care control; n = 14 low-dose; n = 12 high-dose), and 38 participants completed the study (97% follow-up). Over 6 months, the low-dose group completed 142 minutes per week (92.8% adherence), and the high-dose group completed 247 minutes per week (89.0% adherence) of exercise. Compared with the control group, changes in soluble intercellular adhesion molecule-1 were −134.9 ng/mL (95% confidence interval, −238.1 to −31.6 ng/mL) in the low-dose group and −114.8 ng/mL (95% confidence interval, −222.5 to −7.1 ng/mL) in the high-dose group (linear P trend =.023; nonlinear P trend =.044). No changes were observed for soluable vascular adhesion molecule-1 (linear P trend =.791; nonlinear P trend =.604). Non-serious adverse events occurred at similar rates among randomized groups. No serious adverse events occurred. Conclusion: Higher volumes of moderate-intensity aerobic exercise, up to 300 minutes per week, are feasible, safe, and elicit favorable changes in prognostic biomarkers among patients recently treated for stage I to III colon cancer. These data can be used to guide clinical recommendations for patients, and inform future trials.

Original languageEnglish (US)
Pages (from-to)32-40
Number of pages9
JournalClinical Colorectal Cancer
Volume17
Issue number1
DOIs
StatePublished - Mar 1 2018

Fingerprint

Colonic Neoplasms
Survivors
Exercise
Recurrence
Intercellular Adhesion Molecule-1
Blood Vessels
Biomarkers
Confidence Intervals
Observational Studies
Safety
Control Groups

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology

Cite this

Brown, Justin C. ; Troxel, Andrea B. ; Ky, Bonnie ; Damjanov, Nevena ; Zemel, Babette S. ; Rickels, Michael R. ; Rhim, Andrew D. ; Rustgi, Anil K. ; Courneya, Kerry S. ; Schmitz, Kathryn. / Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors : A Randomized Phase II Trial. In: Clinical Colorectal Cancer. 2018 ; Vol. 17, No. 1. pp. 32-40.
@article{559c130679e541749a3cc7b048643317,
title = "Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial",
abstract = "Postdiagnosis physical activity is associated with a lower risk of disease recurrence among survivors of colon cancer. Thirty-nine stage I to III survivors of colon cancer were randomized to usual-care control, 150 minutes per week, or 300 minutes per week of aerobic exercise for 6 months. Exercise was feasible, well-tolerated, and elicited changes in physiologic markers associated with disease recurrence. This study informs future phase II/III trials. Background: Observational studies suggest that higher volumes of physical activity are associated with a lower risk of disease recurrence among survivors of colon cancer. However, the feasibility and safety of prescribing higher volumes of physical activity to survivors of colon cancer are unknown. Furthermore, the pathways through which exercise may reduce disease recurrence are unknown. Patients and Methods: Survivors of stage I to III colon cancer were randomized to usual-care control, 150 minutes per week of aerobic exercise (low-dose), or 300 minutes per week of aerobic exercise (high-dose). Changes in soluble intercellular adhesion molecule-1 and vascular adhesion molecule-1 prognostic biomarkers were examined. Results: From January 2015 to February 2016, 39 patients were enrolled (n = 13 usual-care control; n = 14 low-dose; n = 12 high-dose), and 38 participants completed the study (97{\%} follow-up). Over 6 months, the low-dose group completed 142 minutes per week (92.8{\%} adherence), and the high-dose group completed 247 minutes per week (89.0{\%} adherence) of exercise. Compared with the control group, changes in soluble intercellular adhesion molecule-1 were −134.9 ng/mL (95{\%} confidence interval, −238.1 to −31.6 ng/mL) in the low-dose group and −114.8 ng/mL (95{\%} confidence interval, −222.5 to −7.1 ng/mL) in the high-dose group (linear P trend =.023; nonlinear P trend =.044). No changes were observed for soluable vascular adhesion molecule-1 (linear P trend =.791; nonlinear P trend =.604). Non-serious adverse events occurred at similar rates among randomized groups. No serious adverse events occurred. Conclusion: Higher volumes of moderate-intensity aerobic exercise, up to 300 minutes per week, are feasible, safe, and elicit favorable changes in prognostic biomarkers among patients recently treated for stage I to III colon cancer. These data can be used to guide clinical recommendations for patients, and inform future trials.",
author = "Brown, {Justin C.} and Troxel, {Andrea B.} and Bonnie Ky and Nevena Damjanov and Zemel, {Babette S.} and Rickels, {Michael R.} and Rhim, {Andrew D.} and Rustgi, {Anil K.} and Courneya, {Kerry S.} and Kathryn Schmitz",
year = "2018",
month = "3",
day = "1",
doi = "10.1016/j.clcc.2017.06.001",
language = "English (US)",
volume = "17",
pages = "32--40",
journal = "Clinical Colorectal Cancer",
issn = "1533-0028",
publisher = "Elsevier",
number = "1",

}

Brown, JC, Troxel, AB, Ky, B, Damjanov, N, Zemel, BS, Rickels, MR, Rhim, AD, Rustgi, AK, Courneya, KS & Schmitz, K 2018, 'Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial', Clinical Colorectal Cancer, vol. 17, no. 1, pp. 32-40. https://doi.org/10.1016/j.clcc.2017.06.001

Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors : A Randomized Phase II Trial. / Brown, Justin C.; Troxel, Andrea B.; Ky, Bonnie; Damjanov, Nevena; Zemel, Babette S.; Rickels, Michael R.; Rhim, Andrew D.; Rustgi, Anil K.; Courneya, Kerry S.; Schmitz, Kathryn.

In: Clinical Colorectal Cancer, Vol. 17, No. 1, 01.03.2018, p. 32-40.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors

T2 - A Randomized Phase II Trial

AU - Brown, Justin C.

AU - Troxel, Andrea B.

AU - Ky, Bonnie

AU - Damjanov, Nevena

AU - Zemel, Babette S.

AU - Rickels, Michael R.

AU - Rhim, Andrew D.

AU - Rustgi, Anil K.

AU - Courneya, Kerry S.

AU - Schmitz, Kathryn

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Postdiagnosis physical activity is associated with a lower risk of disease recurrence among survivors of colon cancer. Thirty-nine stage I to III survivors of colon cancer were randomized to usual-care control, 150 minutes per week, or 300 minutes per week of aerobic exercise for 6 months. Exercise was feasible, well-tolerated, and elicited changes in physiologic markers associated with disease recurrence. This study informs future phase II/III trials. Background: Observational studies suggest that higher volumes of physical activity are associated with a lower risk of disease recurrence among survivors of colon cancer. However, the feasibility and safety of prescribing higher volumes of physical activity to survivors of colon cancer are unknown. Furthermore, the pathways through which exercise may reduce disease recurrence are unknown. Patients and Methods: Survivors of stage I to III colon cancer were randomized to usual-care control, 150 minutes per week of aerobic exercise (low-dose), or 300 minutes per week of aerobic exercise (high-dose). Changes in soluble intercellular adhesion molecule-1 and vascular adhesion molecule-1 prognostic biomarkers were examined. Results: From January 2015 to February 2016, 39 patients were enrolled (n = 13 usual-care control; n = 14 low-dose; n = 12 high-dose), and 38 participants completed the study (97% follow-up). Over 6 months, the low-dose group completed 142 minutes per week (92.8% adherence), and the high-dose group completed 247 minutes per week (89.0% adherence) of exercise. Compared with the control group, changes in soluble intercellular adhesion molecule-1 were −134.9 ng/mL (95% confidence interval, −238.1 to −31.6 ng/mL) in the low-dose group and −114.8 ng/mL (95% confidence interval, −222.5 to −7.1 ng/mL) in the high-dose group (linear P trend =.023; nonlinear P trend =.044). No changes were observed for soluable vascular adhesion molecule-1 (linear P trend =.791; nonlinear P trend =.604). Non-serious adverse events occurred at similar rates among randomized groups. No serious adverse events occurred. Conclusion: Higher volumes of moderate-intensity aerobic exercise, up to 300 minutes per week, are feasible, safe, and elicit favorable changes in prognostic biomarkers among patients recently treated for stage I to III colon cancer. These data can be used to guide clinical recommendations for patients, and inform future trials.

AB - Postdiagnosis physical activity is associated with a lower risk of disease recurrence among survivors of colon cancer. Thirty-nine stage I to III survivors of colon cancer were randomized to usual-care control, 150 minutes per week, or 300 minutes per week of aerobic exercise for 6 months. Exercise was feasible, well-tolerated, and elicited changes in physiologic markers associated with disease recurrence. This study informs future phase II/III trials. Background: Observational studies suggest that higher volumes of physical activity are associated with a lower risk of disease recurrence among survivors of colon cancer. However, the feasibility and safety of prescribing higher volumes of physical activity to survivors of colon cancer are unknown. Furthermore, the pathways through which exercise may reduce disease recurrence are unknown. Patients and Methods: Survivors of stage I to III colon cancer were randomized to usual-care control, 150 minutes per week of aerobic exercise (low-dose), or 300 minutes per week of aerobic exercise (high-dose). Changes in soluble intercellular adhesion molecule-1 and vascular adhesion molecule-1 prognostic biomarkers were examined. Results: From January 2015 to February 2016, 39 patients were enrolled (n = 13 usual-care control; n = 14 low-dose; n = 12 high-dose), and 38 participants completed the study (97% follow-up). Over 6 months, the low-dose group completed 142 minutes per week (92.8% adherence), and the high-dose group completed 247 minutes per week (89.0% adherence) of exercise. Compared with the control group, changes in soluble intercellular adhesion molecule-1 were −134.9 ng/mL (95% confidence interval, −238.1 to −31.6 ng/mL) in the low-dose group and −114.8 ng/mL (95% confidence interval, −222.5 to −7.1 ng/mL) in the high-dose group (linear P trend =.023; nonlinear P trend =.044). No changes were observed for soluable vascular adhesion molecule-1 (linear P trend =.791; nonlinear P trend =.604). Non-serious adverse events occurred at similar rates among randomized groups. No serious adverse events occurred. Conclusion: Higher volumes of moderate-intensity aerobic exercise, up to 300 minutes per week, are feasible, safe, and elicit favorable changes in prognostic biomarkers among patients recently treated for stage I to III colon cancer. These data can be used to guide clinical recommendations for patients, and inform future trials.

UR - http://www.scopus.com/inward/record.url?scp=85021314484&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021314484&partnerID=8YFLogxK

U2 - 10.1016/j.clcc.2017.06.001

DO - 10.1016/j.clcc.2017.06.001

M3 - Article

C2 - 28669606

AN - SCOPUS:85021314484

VL - 17

SP - 32

EP - 40

JO - Clinical Colorectal Cancer

JF - Clinical Colorectal Cancer

SN - 1533-0028

IS - 1

ER -