Abstract

BackgroundThe Rehabilitation Strategies Following Esophagogastric cancer (ReStOre) randomized control trial demonstrated a significant improvement in cardiorespiratory fitness of esophagogastric cancer survivors. This follow-up, exploratory study analyzed the biological effect of exercise intervention on levels of 55 serum proteins, encompassing mediators of angiogenesis, inflammation, and vascular injury, from participants on the ReStOre trial.MethodsPatients >6 months disease free from esophagogastric cancer were randomized to usual care or the 12-week ReStOre program (exercise training, dietary counselling, and multidisciplinary education). Serum was collected at baseline (T0), post-intervention (T1), and at 3-month follow up (T2). Serum biomarkers were quantified by enzyme-linked immunosorbent assay (ELISA).ResultsThirty-seven patients participated in this study; 17 in the control arm and 20 in the intervention arm. Exercise intervention resulted in significant alterations in the level of expression of serum IP-10 (mean difference (MD): 38.02 (95% CI: 0.69 to 75.35)), IL-27 (MD: 249.48 (95% CI: 22.43 to 476.53)), and the vascular injury biomarkers, ICAM-1 (MD: 1.05 (95% CI: 1.07 to 1.66)), and VCAM-1 (MD: 1.51 (95% CI: 1.04 to 2.14)) at T1. A significant increase in eotaxin-3 (MD: 2.59 (95% CI: 0.23 to 4.96)), IL-15 (MD: 0.27 (95% CI: 0 to 0.54)) and decrease in bFGF (MD: 1.62 (95% CI: -2.99 to 0.26)) expression was observed between control and intervention cohorts at T2 (p<0.05).ConclusionsExercise intervention significantly altered the expression of a number of serum biomarkers in disease-free patients who had prior treatment for esophagogastric cancer.ImpactExercise rehabilitation causes a significant biological effect on serum biomarkers in esophagogastric cancer survivors.Clinical Trial RegistrationClinicalTrials.gov (NCT03314311).

Highlights

  • While the historical advice to cancer patients was rest and avoidance of physical activity, there is compelling evidence which demonstrates that physical activity is safe for cancer survivors but extremely beneficial in improving health related quality of life, reducing levels of anxiety, fatigue, and depression [1]

  • In this study we have demonstrated that physical activity alters the secretion of a number of markers including eotaxin-3, IP-10, Basic fibroblast growth factor (bFGF), IL-27, ICAM-1, and VCAM-1

  • Adherence to exercise was reflected in cardiorespiratory fitness levels measured by VO2 peak which were consistently higher in the intervention cohort compared to control at time 1 (T1) and time 2 (T2) [13]

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Summary

Introduction

While the historical advice to cancer patients was rest and avoidance of physical activity, there is compelling evidence which demonstrates that physical activity is safe for cancer survivors but extremely beneficial in improving health related quality of life, reducing levels of anxiety, fatigue, and depression [1]. Chemotherapy, radiation and surgery have a detrimental effect on health related quality of life (HRQOL) and patients can struggle with loss of appetite, difficulty eating, sarcopenia, fatigue, and long standing post-operative weight loss [4, 6,7,8,9]. The Rehabilitation Strategies Following Esophagogastric cancer (ReStOre) randomized control trial demonstrated a significant improvement in cardiorespiratory fitness of esophagogastric cancer survivors. This follow-up, exploratory study analyzed the biological effect of exercise intervention on levels of 55 serum proteins, encompassing mediators of angiogenesis, inflammation, and vascular injury, from participants on the ReStOre trial

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