TY - JOUR
T1 - Associations of physical activity with survival and progression in metastatic colorectal cancer
T2 - Results from Cancer and Leukemia Group B (Alliance)/SWOG 80405
AU - Guercio, Brendan J.
AU - Zhang, Sui
AU - Ou, Fang Shu
AU - Venook, Alan P.
AU - Niedzwiecki, Donna
AU - Lenz, Heinz Josef
AU - Innocenti, Federico
AU - O’Neil, Bert H.
AU - Shaw, James E.
AU - Polite, Blase N.
AU - Hochster, Howard S.
AU - Atkins, James N.
AU - Goldberg, Richard M.
AU - Sato, Kaori
AU - Ng, Kimmie
AU - Van Blarigan, Erin
AU - Mayer, Robert J.
AU - Blanke, Charles D.
AU - O’Reilly, Eileen M.
AU - Fuchs, Charles S.
AU - Meyerhardt, Jeffrey A.
N1 - Funding Information:
Supported by the National Institutes of Health Grants No. U10-CA180821 (Alliance Chairman’s Grant to the Alliance for Clinical Trials in Oncology) and U10-CA180882 (Alliance Statistics and Data Center Grant to the Alliance for Clinical Trials in Oncology); U10-CA180791, U10-CA180795, U10-CA180826, U10-CA180836, U10-CA180838, U10-CA180850, U10-CA180867, UG1-CA189858, and UG1-CA189869; U10-CA180820 (ECOG-ACRIN); U10-CA180888 and U10-CA180830 (SWOG); R01-CA149222, R01-CA169141, R01-CA118553, K07-CA197077, R01-CA205406, and CA180820; and the Stand-Up-to-Cancer Colorectal Dream Team Grant. Supported in part by funds from Bristol-Myers Squibb, Genentech, Eli Lily, Pfizer, and Sanofi. Supported by the Douglas Gray Woodruff Chair fund, the Guo Shu Shi Fund, Anonymous Family Fund for Innovations in Colorectal Cancer, and the George Stone Family Foundation (J.M). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The National Cancer Institute helped design the study and participated in review of the manuscript. Nongovernment sponsors of the study played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2019 by American Society of Clinical Oncology
PY - 2019/10/10
Y1 - 2019/10/10
N2 - PURPOSE Regular physical activity is associated with reduced risk of recurrence and mortality in patients with nonmetastatic colorectal cancer. Its influence on patients with advanced/metastatic colorectal cancer (mCRC) has been largely unexplored. PATIENTS AND METHODS We conducted a prospective cohort study nested in Cancer and Leukemia Group B (Alliance)/SWOG 80405 (ClinicalTrials.gov identifier: NCT00265850), a National Cancer Institute–sponsored phase III trial of systemic therapy for mCRC. Within 1 month after therapy initiation, patients were invited to complete a validated questionnaire that reported average physical activity over the previous 2 months. On the basis of responses, we calculated metabolic equivalent task (MET) hours per week to quantify physical activity. The primary end point of the clinical trial and this companion study was overall survival (OS). Secondary end points included progression-free survival (PFS) and first grade 3 or greater treatment-related adverse events. To minimize confounding by poor and declining health, we excluded patients who experienced progression or died within 60 days of activity assessment and used Cox proportional hazards regression analysis to adjust for known prognostic factors, comorbidities, and weight loss. RESULTS The final cohort included 1,218 patients. Compared with patients engaged in less than 3 MET hours per week of physical activity, patients engaged in 18 or more MET hours per week experienced an adjusted hazard ratio for OS of 0.85 (95% CI, 0.71 to 1.02; PTrend = .06) and for PFS of 0.83 (95% CI, 0.70 to 0.99; PTrend = .01). Compared with patients engaging in less than 9 MET hours per week, patients engaging in 9 or more MET hours per week experienced an adjusted hazard ratio for grade 3 or greater treatment-related adverse events of 0.73 (95% CI, 0.62 to 0.86; PTrend , .001). CONCLUSION Among patients with mCRC in Cancer and Leukemia Group B (Alliance)/SWOG 80405, association of physical activity with OS was not statistically significant. Greater physical activity was associated with longer PFS and lower adjusted risk for first grade 3 or greater treatment-related adverse events.
AB - PURPOSE Regular physical activity is associated with reduced risk of recurrence and mortality in patients with nonmetastatic colorectal cancer. Its influence on patients with advanced/metastatic colorectal cancer (mCRC) has been largely unexplored. PATIENTS AND METHODS We conducted a prospective cohort study nested in Cancer and Leukemia Group B (Alliance)/SWOG 80405 (ClinicalTrials.gov identifier: NCT00265850), a National Cancer Institute–sponsored phase III trial of systemic therapy for mCRC. Within 1 month after therapy initiation, patients were invited to complete a validated questionnaire that reported average physical activity over the previous 2 months. On the basis of responses, we calculated metabolic equivalent task (MET) hours per week to quantify physical activity. The primary end point of the clinical trial and this companion study was overall survival (OS). Secondary end points included progression-free survival (PFS) and first grade 3 or greater treatment-related adverse events. To minimize confounding by poor and declining health, we excluded patients who experienced progression or died within 60 days of activity assessment and used Cox proportional hazards regression analysis to adjust for known prognostic factors, comorbidities, and weight loss. RESULTS The final cohort included 1,218 patients. Compared with patients engaged in less than 3 MET hours per week of physical activity, patients engaged in 18 or more MET hours per week experienced an adjusted hazard ratio for OS of 0.85 (95% CI, 0.71 to 1.02; PTrend = .06) and for PFS of 0.83 (95% CI, 0.70 to 0.99; PTrend = .01). Compared with patients engaging in less than 9 MET hours per week, patients engaging in 9 or more MET hours per week experienced an adjusted hazard ratio for grade 3 or greater treatment-related adverse events of 0.73 (95% CI, 0.62 to 0.86; PTrend , .001). CONCLUSION Among patients with mCRC in Cancer and Leukemia Group B (Alliance)/SWOG 80405, association of physical activity with OS was not statistically significant. Greater physical activity was associated with longer PFS and lower adjusted risk for first grade 3 or greater treatment-related adverse events.
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U2 - 10.1200/JCO.19.01019
DO - 10.1200/JCO.19.01019
M3 - Article
C2 - 31408415
AN - SCOPUS:85072992561
SN - 0732-183X
VL - 37
SP - 2620
EP - 2631
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 29
ER -