A recent study1 finding significantly longer progression-free survival and reduced risk for treatment-related toxicities among patients with metastatic colorectal cancer being treated with chemotherapy can have immediate application, albeit with some caveats related to the observational nature of the study and the particular patient population.
Good Performance Status
“Our study was conducted in a population of patients who had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at baseline, meaning that all patients were either fully active or at least able to carry out activities such as light housework or office work,” Brendan J. Guercio, MD, of Memorial Sloan Kettering Cancer Center, New York, told The ASCO Post. “Our study certainly suggests that moderate physical activity may benefit patients with colorectal cancer and that moderate physical activity is unlikely to harm such patients. So it is likely safe for physicians to recommend regular moderate activity to patients with metastatic colorectal cancer just as physicians would for any patient, with or without cancer, who wishes to stay in good health,” he noted.
“I would stress that although physical activity was associated with better outcomes in our study population, each patient is different and has unique needs,” Dr. Guercio continued. “Therefore, it is important for patients with cancer to always talk with their physician first about the risks and benefits of new exercise routines prior to making significant changes to their lifestyle habits.”
What Are They Doing Now?
An important first step is “discussing with patients what they are actually doing in terms of physical activity and exercise,” advised senior author Jeffrey A. Meyerhardt, MD, MPH, FASCO, of Dana-Farber Cancer Institute and Harvard Medical School, Boston. Strategies can then be developed “for those patients who aren’t engaging in activity or who feel like they are struggling to do so. There are programs through the YMCA and through the LIVESTRONG program that can help these patients. Depending on where you are in the country, you may have different programs and opportunities and need to think through what the right program is for your individual patient.”
He added, “This study helps justify thinking about a larger effort. Some of these issues about how to intervene with patients at different stages in their disease continuum still need to be sorted out, in terms of what is the right way to be able to safely change behavior.” ■
DISCLOSURE: Dr. Guercio has received institutional research funding from Bristol-Myers Squibb, Eli Lilly and Company, Genentech, Pfizer, and Sanofi. Dr. Meyerhardt has received honoraria from Cota Healthcare, Ignyta, and Taiho Pharmaceutical; has served in a consulting or advisory role for Array BioPharma; and has received institutional research funding from Boston Biomedical.
1. Guercio BJ, Zhang S, Ou FS, et al: Associations of physical activity with survival and progression in metastatic colorectal cancer: Results from Cancer and Leukemia Group B (Alliance)/SWOG 80405. J Clin Oncol August 13, 2019 (early release online).
Patients who were being treated with chemotherapy for metastatic colorectal cancer and who reported engaging in physical activity had a significantly longer progression-free survival and reduced risk for treatment-related adverse events than did those reporting less physical activity, according to...