Feasibility of exercise during oxaliplatin infusions to reduce neuropathy in patients with gastrointestinal cancer.

Abstract

244 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of oxaliplatin, often leading to discontinuation of therapy and persistent functional impairment. Limited evidence suggests that exercise may reduce risk and severity of CIPN. This pilot study assessed feasibility and acceptability of an exercise intervention during oxaliplatin infusions over a 3-month period. Methods: Patients (≥18 years) with gastrointestinal malignancies receiving oxaliplatin participated in this prospective, single-arm study. Patients exercised for 30 minutes during 6 infusions, using hand and foot pedal machines for upper and lower extremity exercise. Feasibility and acceptability were evaluated by patient report, using Weiner’s Feasibility and Acceptability of Intervention Measures (FIM and AIM, scored 1-5). We defined feasibility and acceptability as a composite score of ≥4 on the FIM and AIM for ≥60% of subjects, respectively. We evaluated CIPN severity (via EORTC-CIPN20) and quality of life (via PROMIS-29) at baseline, 8 weeks (wks), and 14 wks. We calculated descriptive statistics and tested for changes over time using a mixed effects model. Results: Ten patients (median age 64 years, 50% men) enrolled, comprising all patients approached. Nine of 10 patients completed all planned exercise sessions. Nine of 10 patients found the intervention feasible (median FIM score = 4, IQR 4-4.75) and 6 of 10 found it acceptable (median AIM = 4, IQR 3.56-4.19). Patients reported decreasing anxiety (p=0.02) and increasing fatigue (p=0.02) over the 3-month period. In an exit survey, 3 of 9 patients agreed with the statement “I found myself wanting to exercise more over the past several weeks”. In free-text, 6/9 patients stated that they enjoyed the intervention. Conclusions: The intervention of upper and lower extremity exercise during oxaliplatin infusions over a 3-month period met the pre-defined study objectives of patient-reported feasibility and acceptability. Most patients indicated that they enjoyed the exercise intervention and that participating in this study encouraged them to exercise more on their own time. Further study is needed to evaluate the effectiveness of the intervention for reducing CIPN. Clinical trial information: NCT05916118 .[Table: see text]