Cancer Medicine (Jul 2023)

Randomized trial of exercise on cancer‐related blood biomarkers and survival in women with ovarian cancer

  • Brenda Cartmel,
  • Fang‐yong Li,
  • Yang Zhou,
  • Linda Gottlieb,
  • Lingeng Lu,
  • Reed Mszar,
  • Maura Harrigan,
  • Jennifer A. Ligibel,
  • Radhika Gogoi,
  • Peter E. Schwartz,
  • Harvey A. Risch,
  • Melinda L. Irwin

DOI
https://doi.org/10.1002/cam4.6187
Journal volume & issue
Vol. 12, no. 14
pp. 15492 – 15503

Abstract

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Abstract Background In randomized trials in women with breast cancer, exercise has been shown to have beneficial effects on cancer‐related circulating biomarkers that may impact survival. Such studies are lacking for ovarian cancer. Methods This secondary analysis of a published randomized controlled trial examined the impact of a 6‐month exercise intervention versus attention‐control on change in prespecified circulating biomarkers (cancer antigen 125 (CA‐125), C‐reactive protein (CRP), insulin‐like growth factor‐1(IGF‐1), insulin and leptin) in a subset of participants who provided a fasting blood draw (N = 104/144) at enrollment and at 6 months. Change in biomarkers between study arms was compared using a linear mixed effects model analysis. An exploratory analysis of the exercise intervention versus attention‐control on all‐cause mortality included all (N = 144) participants. All statistical tests were two‐sided. Results Participants included in the biomarker analysis were 57.0 ± 8.8 (mean ± SD) years old and 1.6 ± 0.9 years post‐diagnosis. Adherence to the exercise intervention was 176.4 ± 63.5 min/week. Post intervention IGF‐1 (group difference in change: −14.2 (−26.1 to −2.3) ng/mL (least squared means (95% CI))) and leptin (−8.9 (−16.5 to −1.4) ng/mL) were significantly reduced in the exercise group (N = 53) compared to those in attention‐control (N = 51). No group difference in change was seen for CA‐125 (p = 0.54), CRP (p = 0.95), or insulin (p = 0.37). With median follow‐up of 70 months [range 6.6–105.4 months], 50/144 (34.7%) (exercise group; 24/74 (32.4%) versus attention‐control group; 26/70 (37.1%)) participants died with no between group difference in overall survival (p = 0.99). Conclusions Further studies are needed to determine the clinical significance of exercise‐induced changes in cancer‐related circulating biomarkers in women with ovarian cancer.

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