Abstract
Simple SummaryCancer treatments can cause adverse effects such as cancer-related fatigue. Immune checkpoint inhibitors (ICIs) are a relatively new therapy for some cancers and have shown great promise in helping people. Physical activity has been shown to aid many cancer patients to overcome adverse effects in traditional chemotherapy, but along with ICIs, it hasn’t been fully examined. This study was carried out to describe where the current research is now and to find knowledge gaps to help shape future research with ICIs, physical activity, and cancer outcomes.Background: Cancer therapies are associated with multiple adverse effects, including (but not limited to) cancer-related fatigue (CRF). Fatigue is one of the most common side effects of immune checkpoint inhibitors (ICIs), occurring in up to 25% of patients. Physical activity has been shown to help reduce CRF through modulating the immune system, and may synergistically aid in the anti-tumor effects of ICIs. This review describes the nature and scope of evidence for the effects associated with concurrent physical activity while undergoing ICI therapy. Method: Scoping review methodology was utilized to identify studies, extract data, and collate and summarize results. Results: In literature published from January 2010 through to August 2021, only one human study and three pre-clinical studies met inclusion criteria. Conclusion: Existing evidence supports that physical activity is associated with decreased treatment-related toxicities such as CRF. However, further investigation is warranted. The dearth of clinical studies illustrates the need for more research to address this question, to guide patients and their providers in the application of appropriate physical activity interventions in those patients undergoing ICI.
Highlights
No restrictions were placed on type of physical activity, so long as the activity was concurrent with administration of immune checkpoint inhibitors (ICIs) and the outcomes of both physical activity and concurrent ICI administration were reported
Neutrophil tumor infiltration was higher in the physically active group in combination with nivolumab group (p = 0.018) compared to the inactive group, and VEGF-A expression was higher in the nivolumab group, regardless of physical activity status. The aim of this scoping review was to elucidate the extent of published research evaluating the effects of concurrent physical activity interventions and the use of ICIs
The results of the scoping review suggest that the current availability of research is lacking to inform the use of concurrent administration of physical activity or increased physical activity and ICIs
Summary
Immune checkpoint inhibitors (ICIs) have demonstrated clinical efficacy in multiple cancer settings. Pembrolizumab became the first anti-neoplastic medication approved across solid tumors solely based on a biomarker, as a result of early studies including the phase 2 KEYNOTE-158 trial [2]. Cancer therapies are associated with multiple adverse effects, including (but not limited to) cancer-related fatigue (CRF). Fatigue is one of the most common side effects of immune checkpoint inhibitors (ICIs), occurring in up to 25% of patients. Physical activity has been shown to help reduce CRF through modulating the immune system, and may synergistically aid in the anti-tumor effects of ICIs. This review describes the nature and scope of evidence for the effects associated with concurrent physical activity while undergoing ICI therapy. Method: Scoping review methodology was utilized to identify studies, extract data, and collate and summarize results
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