Targeting exercise interventions to patients with cancer in need: An individual patient data meta-analysis

Maike G. Sweegers, Anne M. May, Mai J. Chinapaw, Jonna K. Van Vulpen, Rob U. Newton, Daniel A. Galvão, Neil K. Aaronson, Martijn M. Stuiver, Paul B. Jacobsen, Irma M. Verdonck-De Leeuw, Karen Steindorf, Melinda L. Irwin, Sandi Hayes, Kathleen A. Griffith, Alejandro Lucia, Fernando Herrero-Roman, Ilse Mesters, Ellen Van Weert, Hans Knoop, Martine M. GoedendorpNanette Mutrie, Amanda J. Daley, Alex McConnachie, Martin Bohus, Lene Thorsen, Karl Heinz Schulz, Camille E. Short, Erica L. James, Ronald C. Plotnikoff, Gill Arbane, Martina E. Schmidt, Karin Potthoff, Marc Van Beurden, Hester S. Oldenburg, Gabe S. Sonke, Wim H. Van Harten, Rachel Garrod, Kathryn H. Schmitz, Kerri M. Winters-Stone, Miranda J. Velthuis, Dennis R. Taaffe, Willem Van Mechelen, Marie Jose Kersten, Frans Nollet, Jennifer Wenzel, Joachim Wiskemann, Johannes Brug, Kerry S. Courneya, Laurien M. Buffart

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and posttreatment. Methods: Individual patient data from 34 randomized exercise trials (n ¼ 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (P interaction ¼.05) and worse PF (P interaction ¼.003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (P interaction ¼.002). Post-treatment, effects on upper (P interaction <.001) and lower (P interaction ¼.01) body muscle strength and QoL (P interaction <.001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.

Original languageEnglish (US)
Article numberdjy161
JournalJournal of the National Cancer Institute
Volume110
Issue number11
DOIs
StatePublished - Jan 1 2018

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Meta-Analysis
Exercise
Neoplasms
Fatigue
Muscle Strength
Quality of Life
Therapeutics
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Sweegers, M. G., May, A. M., Chinapaw, M. J., Van Vulpen, J. K., Newton, R. U., Galvão, D. A., ... Buffart, L. M. (2018). Targeting exercise interventions to patients with cancer in need: An individual patient data meta-analysis. Journal of the National Cancer Institute, 110(11), [djy161]. https://doi.org/10.1093/jnci/djy161
Sweegers, Maike G. ; May, Anne M. ; Chinapaw, Mai J. ; Van Vulpen, Jonna K. ; Newton, Rob U. ; Galvão, Daniel A. ; Aaronson, Neil K. ; Stuiver, Martijn M. ; Jacobsen, Paul B. ; Verdonck-De Leeuw, Irma M. ; Steindorf, Karen ; Irwin, Melinda L. ; Hayes, Sandi ; Griffith, Kathleen A. ; Lucia, Alejandro ; Herrero-Roman, Fernando ; Mesters, Ilse ; Van Weert, Ellen ; Knoop, Hans ; Goedendorp, Martine M. ; Mutrie, Nanette ; Daley, Amanda J. ; McConnachie, Alex ; Bohus, Martin ; Thorsen, Lene ; Schulz, Karl Heinz ; Short, Camille E. ; James, Erica L. ; Plotnikoff, Ronald C. ; Arbane, Gill ; Schmidt, Martina E. ; Potthoff, Karin ; Van Beurden, Marc ; Oldenburg, Hester S. ; Sonke, Gabe S. ; Van Harten, Wim H. ; Garrod, Rachel ; Schmitz, Kathryn H. ; Winters-Stone, Kerri M. ; Velthuis, Miranda J. ; Taaffe, Dennis R. ; Van Mechelen, Willem ; Kersten, Marie Jose ; Nollet, Frans ; Wenzel, Jennifer ; Wiskemann, Joachim ; Brug, Johannes ; Courneya, Kerry S. ; Buffart, Laurien M. / Targeting exercise interventions to patients with cancer in need : An individual patient data meta-analysis. In: Journal of the National Cancer Institute. 2018 ; Vol. 110, No. 11.
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title = "Targeting exercise interventions to patients with cancer in need: An individual patient data meta-analysis",
abstract = "Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and posttreatment. Methods: Individual patient data from 34 randomized exercise trials (n ¼ 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (P interaction ¼.05) and worse PF (P interaction ¼.003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (P interaction ¼.002). Post-treatment, effects on upper (P interaction <.001) and lower (P interaction ¼.01) body muscle strength and QoL (P interaction <.001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.",
author = "Sweegers, {Maike G.} and May, {Anne M.} and Chinapaw, {Mai J.} and {Van Vulpen}, {Jonna K.} and Newton, {Rob U.} and Galv{\~a}o, {Daniel A.} and Aaronson, {Neil K.} and Stuiver, {Martijn M.} and Jacobsen, {Paul B.} and {Verdonck-De Leeuw}, {Irma M.} and Karen Steindorf and Irwin, {Melinda L.} and Sandi Hayes and Griffith, {Kathleen A.} and Alejandro Lucia and Fernando Herrero-Roman and Ilse Mesters and {Van Weert}, Ellen and Hans Knoop and Goedendorp, {Martine M.} and Nanette Mutrie and Daley, {Amanda J.} and Alex McConnachie and Martin Bohus and Lene Thorsen and Schulz, {Karl Heinz} and Short, {Camille E.} and James, {Erica L.} and Plotnikoff, {Ronald C.} and Gill Arbane and Schmidt, {Martina E.} and Karin Potthoff and {Van Beurden}, Marc and Oldenburg, {Hester S.} and Sonke, {Gabe S.} and {Van Harten}, {Wim H.} and Rachel Garrod and Schmitz, {Kathryn H.} and Winters-Stone, {Kerri M.} and Velthuis, {Miranda J.} and Taaffe, {Dennis R.} and {Van Mechelen}, Willem and Kersten, {Marie Jose} and Frans Nollet and Jennifer Wenzel and Joachim Wiskemann and Johannes Brug and Courneya, {Kerry S.} and Buffart, {Laurien M.}",
year = "2018",
month = "1",
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doi = "10.1093/jnci/djy161",
language = "English (US)",
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Sweegers, MG, May, AM, Chinapaw, MJ, Van Vulpen, JK, Newton, RU, Galvão, DA, Aaronson, NK, Stuiver, MM, Jacobsen, PB, Verdonck-De Leeuw, IM, Steindorf, K, Irwin, ML, Hayes, S, Griffith, KA, Lucia, A, Herrero-Roman, F, Mesters, I, Van Weert, E, Knoop, H, Goedendorp, MM, Mutrie, N, Daley, AJ, McConnachie, A, Bohus, M, Thorsen, L, Schulz, KH, Short, CE, James, EL, Plotnikoff, RC, Arbane, G, Schmidt, ME, Potthoff, K, Van Beurden, M, Oldenburg, HS, Sonke, GS, Van Harten, WH, Garrod, R, Schmitz, KH, Winters-Stone, KM, Velthuis, MJ, Taaffe, DR, Van Mechelen, W, Kersten, MJ, Nollet, F, Wenzel, J, Wiskemann, J, Brug, J, Courneya, KS & Buffart, LM 2018, 'Targeting exercise interventions to patients with cancer in need: An individual patient data meta-analysis', Journal of the National Cancer Institute, vol. 110, no. 11, djy161. https://doi.org/10.1093/jnci/djy161

Targeting exercise interventions to patients with cancer in need : An individual patient data meta-analysis. / Sweegers, Maike G.; May, Anne M.; Chinapaw, Mai J.; Van Vulpen, Jonna K.; Newton, Rob U.; Galvão, Daniel A.; Aaronson, Neil K.; Stuiver, Martijn M.; Jacobsen, Paul B.; Verdonck-De Leeuw, Irma M.; Steindorf, Karen; Irwin, Melinda L.; Hayes, Sandi; Griffith, Kathleen A.; Lucia, Alejandro; Herrero-Roman, Fernando; Mesters, Ilse; Van Weert, Ellen; Knoop, Hans; Goedendorp, Martine M.; Mutrie, Nanette; Daley, Amanda J.; McConnachie, Alex; Bohus, Martin; Thorsen, Lene; Schulz, Karl Heinz; Short, Camille E.; James, Erica L.; Plotnikoff, Ronald C.; Arbane, Gill; Schmidt, Martina E.; Potthoff, Karin; Van Beurden, Marc; Oldenburg, Hester S.; Sonke, Gabe S.; Van Harten, Wim H.; Garrod, Rachel; Schmitz, Kathryn H.; Winters-Stone, Kerri M.; Velthuis, Miranda J.; Taaffe, Dennis R.; Van Mechelen, Willem; Kersten, Marie Jose; Nollet, Frans; Wenzel, Jennifer; Wiskemann, Joachim; Brug, Johannes; Courneya, Kerry S.; Buffart, Laurien M.

In: Journal of the National Cancer Institute, Vol. 110, No. 11, djy161, 01.01.2018.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Targeting exercise interventions to patients with cancer in need

T2 - An individual patient data meta-analysis

AU - Sweegers, Maike G.

AU - May, Anne M.

AU - Chinapaw, Mai J.

AU - Van Vulpen, Jonna K.

AU - Newton, Rob U.

AU - Galvão, Daniel A.

AU - Aaronson, Neil K.

AU - Stuiver, Martijn M.

AU - Jacobsen, Paul B.

AU - Verdonck-De Leeuw, Irma M.

AU - Steindorf, Karen

AU - Irwin, Melinda L.

AU - Hayes, Sandi

AU - Griffith, Kathleen A.

AU - Lucia, Alejandro

AU - Herrero-Roman, Fernando

AU - Mesters, Ilse

AU - Van Weert, Ellen

AU - Knoop, Hans

AU - Goedendorp, Martine M.

AU - Mutrie, Nanette

AU - Daley, Amanda J.

AU - McConnachie, Alex

AU - Bohus, Martin

AU - Thorsen, Lene

AU - Schulz, Karl Heinz

AU - Short, Camille E.

AU - James, Erica L.

AU - Plotnikoff, Ronald C.

AU - Arbane, Gill

AU - Schmidt, Martina E.

AU - Potthoff, Karin

AU - Van Beurden, Marc

AU - Oldenburg, Hester S.

AU - Sonke, Gabe S.

AU - Van Harten, Wim H.

AU - Garrod, Rachel

AU - Schmitz, Kathryn H.

AU - Winters-Stone, Kerri M.

AU - Velthuis, Miranda J.

AU - Taaffe, Dennis R.

AU - Van Mechelen, Willem

AU - Kersten, Marie Jose

AU - Nollet, Frans

AU - Wenzel, Jennifer

AU - Wiskemann, Joachim

AU - Brug, Johannes

AU - Courneya, Kerry S.

AU - Buffart, Laurien M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and posttreatment. Methods: Individual patient data from 34 randomized exercise trials (n ¼ 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (P interaction ¼.05) and worse PF (P interaction ¼.003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (P interaction ¼.002). Post-treatment, effects on upper (P interaction <.001) and lower (P interaction ¼.01) body muscle strength and QoL (P interaction <.001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.

AB - Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and posttreatment. Methods: Individual patient data from 34 randomized exercise trials (n ¼ 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (P interaction ¼.05) and worse PF (P interaction ¼.003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (P interaction ¼.002). Post-treatment, effects on upper (P interaction <.001) and lower (P interaction ¼.01) body muscle strength and QoL (P interaction <.001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.

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U2 - 10.1093/jnci/djy161

DO - 10.1093/jnci/djy161

M3 - Review article

C2 - 30299508

AN - SCOPUS:85056588080

VL - 110

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 11

M1 - djy161

ER -