A prospective cohort study within the phase III Cancer and Leukemia Group B (Alliance)/SWOG 80405 trial found that increased physical activity at baseline was associated with nonsignificant improvement in overall survival, a significant improvement in progression-free survival, and a reduced risk of severe toxicity among patients receiving systemic therapy for metastatic colorectal cancer. These findings were reported in the Journal of Clinical Oncology1 by Brendan J. Guercio, MD, and colleagues.
Brendan J. Guercio, MD
Study Details
In the study, patients were invited to complete a questionnaire within 1 month after initiation of therapy that reported average physical activity over the previous 2 months. Metabolic equivalent task hours per week were calculated to quantify level of physical activity. Patients who experienced disease progression or died within 60 days of activity assessment were excluded from analysis. Cox proportional hazards regression analysis was used to adjust for prognostic factors, comorbidities, and weight loss.
Overall, 67% of patients in the trial consented to the physical activity study, with 87% of these completed the study questionnaire. The final cohort included 1,218 patients.
Activity Level and Outcomes
Compared with patients with less than 3 metabolic equivalent task hours per week of physical activity (n = 566, 47% of cohort), adjusted hazard ratios for overall survival were 0.93 (95% confidence interval [CI] = 0.80–1.09) among those with 3 to 8.9 metabolic equivalent task hours (n = 292, 24%), 0.82 (95% CI = 0.67–1.01) among those with 9 to 17.9 metabolic equivalent task hours (n = 148; 12%), and 0.85 (95% CI = 0.71–1.02; P for trend = .06) among those with 18 or more metabolic equivalent task hours (n = 212, 17%).
Compared with patients with less than 3 metabolic equivalent task hours per week, adjusted hazard ratios for progression-free survival were 1.03 (95% CI = 0.88–1.19) among those with 3 to 8.9 metabolic equivalent task hours, 0.81 (95% CI = 0.67–0.99), among those with 9 to 17.9 metabolic equivalent task hours, and 0.83 (95% CI = 0.70–0.99; P for trend = .01) among those with 18 or more metabolic equivalent task hours.
Compared with patients with less than 9 metabolic equivalent task hours per week, those with 9 or more metabolic equivalent task hours exhibited a significantly lower risk of grade ≥ 3 treatment-related adverse events (adjusted hazard ratio = 0.73, 95% CI = 0.62–0.86; P for trend < .001).
The investigators concluded: “Among patients with [metastatic colorectal cancer] in [the] Cancer and Leukemia Group B (Alliance)/SWOG 80405 [trial], association of physical activity with [overall survival] was not statistically significant. Greater physical activity was associated with longer [progression-free survival] and lower adjusted risk for first grade 3 or greater treatment-related adverse events.” ■
DISCLOSURE: For full disclosures of the study authors, visit ascopubs.org/journal/jco.
REFERENCE
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).
