Feasibility and efficacy of a multicomponent exercise medicine programme in patients with pancreatic cancer undergoing neoadjuvant therapy (the EXPAN trial): study protocol of a dual-centre, two-armed phase I randomised controlled trial

Luo, Hao; Galvão, Daniel A.; Newton, Robert U.; Tang, Colin; Dean, Andrew; Jasas, Kevin; Johansson, Mikael; Yusoff, Ian F.; Spry, Nigel; Taaffe, Dennis R.

doi:10.1136/bmjgast-2021-000642

Cited by 5 publications

(3 citation statements)

References 53 publications

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“…In addition, a strong willingness to continue exercise after a maximum 12-week program identifed in the current study provides a rationale for future studies to use a longer-term intervention. An ongoing randomised controlled trial (the EXPAN trial) by our institute of a maximum 6-month intervention of this format in patients with borderline resectable or locally advanced pancreatic cancer undergoing neoadjuvant therapy may provide additional information in this regard [55].…”

Section: Discussionmentioning

confidence: 99%

Multimodal Exercise in Older Patients with Advanced Pancreatic Cancer Undergoing First-Line Chemotherapy: A Case Series Examining Feasibility and Preliminary Efficacy

Luo

Galvão

Newton

et al. 2023

European Journal of Cancer Care

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Purpose. Exercise is emerging as an adjunct therapy to cancer treatment; however, its role in older patients with advanced pancreatic cancer undergoing first-line chemotherapy is unclear. The aim of this study was to primarily provide evidence on feasibility with an exploratory examination of the initial efficacy of exercise in this clinical setting. Materials and Methods. Six patients aged 60–75 years with de novo or recurrent advanced pancreatic cancer undergoing first-line chemotherapy consented to participate in twice-weekly exercise that included resistance and aerobic training and boxing-related activities for up to 12 weeks. Patients were monitored for attendance, adherence, and adverse events. Body composition, muscle strength, functional ability, patient-reported outcome measures, and patient-reported experience measures were assessed at baseline and/or postintervention. Results. Of the 6 patients, 1 withdrew after baseline testing and 5 attended 42%–95% of planned sessions and adhered to 28%–83% of the prescribed exercise. There were no serious exercise-emergent adverse events. All 5 patients increased or maintained lean mass (0.1%–4.4%) and 4 reduced fat mass (−0.4%–−8.6%). Improvements were observed in 4 or all 5 patients for muscle strength (7.1%–75%), 5 times sit-to-stand (1.3%–21.4%), 6-m backward walk (16.5%–35.8%), and patient-reported outcomes. Furthermore, all patients perceived exercise as very helpful in managing their cancer and expressed a strong willingness to continue exercise in the future. Conclusion. A multimodal exercise program appears feasible with potential physical and psychological benefits for older patients with advanced pancreatic cancer undergoing first-line chemotherapy. Further research including a larger sample size is warranted.

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Section: Discussionmentioning

confidence: 99%

Multimodal Exercise in Older Patients with Advanced Pancreatic Cancer Undergoing First-Line Chemotherapy: A Case Series Examining Feasibility and Preliminary Efficacy

Luo

Galvão

Newton

et al. 2023

European Journal of Cancer Care

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“…However, given the exploratory nature of the study, further randomized trials with a larger sample size are warranted to consolidate the current findings. In addition, given that the overall evidence of exercise in PanCa is limited, research in controlled settings and in particular for patients under less investigated treatment phases (e.g., neoadjuvant) (46)(47)(48) are still required to improve our current knowledge of exercise in the management of patients with PanCa.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Clinic-Based Exercise Program in Patients with Pancreatic Cancer Undergoing Nonsurgical Treatment

Luo¹,

Galvão²,

Newton³

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

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IntroductionEvidence regarding the role of exercise in pancreatic cancer (PanCa) is limited and is derived exclusively under tightly controlled research conditions. This study aimed to quantify adherence, adverse events, and changes in physical and psychological outcomes in any patients with PanCa referred to undertake exercise during nonsurgical treatment.MethodsThe study involved 22 patients with localized or metastatic PanCa undertaking a clinic-based exercise program during chemotherapy or chemoradiotherapy. The program included supervised aerobic and resistance exercise undertaken twice weekly for 12 wk and a 12-wk follow-up with supervised exercise optional dependent on patient preference and condition. Patients were monitored for adherence and adverse events. Objective and patient-reported outcomes were assessed at baseline, 12 wk, and 24 wk.ResultsA total of 251 sessions were attended by 19 patients over the first 12 wk (attendance rate, 55%). Complete case analyses indicated significant (P < 0.05) improvements in functional ability (5.2%–17.2%), muscle strength (16.9%–25.1%), and static balance (6.8%). There were no significant changes in body composition or patient-reported outcomes except for sleep quality, which deteriorated; however, at an individual level, several patients had clinically relevant improvements in cancer-related fatigue and quality of life. Patients who continued with supervised exercise to week 24 largely preserved improvements in functional ability, muscle strength, and static balance. No serious adverse events resulted from the exercise program.ConclusionsIndividualized, supervised aerobic and resistance exercise in a clinic-based setting appears to be safe and may improve or maintain physical and psychological health in patients with PanCa undergoing nonsurgical treatment.

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“…FOLFIRINOX, a combination of 5-fluorouracil, leucovorin, oxaliplatin, and irinotecan; SBRT, stereotactic body radiation therapy; RT, radiation therapy; CRT, chemoradiation therapy. interventions still lacking, and further investigations are warranted (72)(73)(74)(75).…”

Section: Future Directionsmentioning

confidence: 99%

Current status and future perspective of neoadjuvant therapy in locally advanced and borderline resectable pancreatic adenocarcinoma: a narrative review

Hyung¹,

Lee²,

Hwang³

et al. 2022

Chin Clin Oncol

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Background and Objective: The concept of neoadjuvant approach for patients with locally advanced pancreatic cancer (LAPC) has been evolving with the advancement in therapeutic modalities. In this narrative review, we aimed to discuss the updates and future perspectives on the treatment of LAPC. Methods:We discussed the recent literature and up-to-date evidence along with the future perspectives for the treatment of LAPC using the neoadjuvant approach. Reviewed literatures were searched by systematic search of PubMed and Google Scholar, including articles published in English between January 1st, 2013, and October 31st, 2021.

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Feasibility and efficacy of a multicomponent exercise medicine programme in patients with pancreatic cancer undergoing neoadjuvant therapy (the EXPAN trial): study protocol of a dual-centre, two-armed phase I randomised controlled trial

Cited by 5 publications

References 53 publications

Multimodal Exercise in Older Patients with Advanced Pancreatic Cancer Undergoing First-Line Chemotherapy: A Case Series Examining Feasibility and Preliminary Efficacy

Multimodal Exercise in Older Patients with Advanced Pancreatic Cancer Undergoing First-Line Chemotherapy: A Case Series Examining Feasibility and Preliminary Efficacy

Evaluation of a Clinic-Based Exercise Program in Patients with Pancreatic Cancer Undergoing Nonsurgical Treatment

Current status and future perspective of neoadjuvant therapy in locally advanced and borderline resectable pancreatic adenocarcinoma: a narrative review

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