Feasibility of delivering supervised exercise training following surgical resection and during adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PRECISE): a case series

Brown, Malcolm; O’Connor, Dominic; Turkington, Richard; Eatock, Martin; Vince, Rebecca; Hulme, Claire; Bowdery, Roy; Robinson, Rebecca; Wadsley, Jonathan; Maraveyas, Anthony; Prue, Gillian

Abstract

IntroductionPancreatic ductal adenocarcinoma (PDAC) is an aggressive neoplasm, with surgical resection and adjuvant chemotherapy the only curative treatment. Treatment-related toxicities place a considerable burden on patients although exercise training has shown promise is helping to manage such adversities and facilitate rehabilitation. The feasibility and safety of exercise training as a supportive therapy during adjuvant chemotherapy remains unknown.MethodsPatients with PDAC were screened post-surgical resection and enrolled in a 16-week, progressive, concurrent exercise programme alongside their chemotherapy regimen. Feasibility was the primary objective detailing recruitment, retention and adherence rates throughout as well as the safety and fidelity of the intervention. Secondarily, the impact on functional fitness and patient-reported outcomes was captured at baseline, post-intervention and 3-month follow up.ResultsEight patients consented to participate in this trial, with five proceeding to enrol in exercise training. Concurrent exercise training is feasible and safe during adjuvant chemotherapy and prevented an expected decline in functional fitness and patient-reported outcomes during this time.DiscussionThis case series provides preliminary evidence that concurrent exercise training during adjuvant therapy is safe, feasible and well tolerated, preventing an expected decline in functional fitness, muscular strength and health-related quality of life (HRQoL). Given the adverse effects of treatment, these findings are promising and provide further evidence for the inclusion of exercise training as a standard of care for surgical rehabilitation and managing treatment-related toxicities. Future research should explore the impact of exercise training during neoadjuvant chemotherapy, with prehabilitation now standard practice for borderline resectable disease.Trial registrationClinicalTrials.gov Identifier: NCT04305067, prospectively registered 12/03/2020, https://classic.Clinicaltrialsgov/ct2/show/NCT04305067 .

Citation

Brown, M., O’Connor, D., Turkington, R., Eatock, M., Vince, R., Hulme, C., …Prue, G. (2023). Feasibility of delivering supervised exercise training following surgical resection and during adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PRECISE): a case series. BMC Sports Science, Medicine and Rehabilitation, 15(1), Article 116. https://doi.org/10.1186/s13102-023-00722-3

• Journal Article Type: Article
• Acceptance Date: Sep 5, 2023
• Online Publication Date: Sep 21, 2023
• Publication Date: Sep 21, 2023
• Deposit Date: Oct 2, 2023
• Publicly Available Date: Oct 3, 2023
• Journal: BMC Sports Science, Medicine and Rehabilitation
• Electronic ISSN: 2052-1847
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 1
• Article Number: 116
• DOI: https://doi.org/10.1186/s13102-023-00722-3
• Keywords: Exercise, Feasibility, Pancreatic Ductal Adenocarcinoma, Patient-reported Outcomes, Functional Fitness
• Public URL: https://nottingham-repository.worktribe.com/output/25645309
• Publisher URL: https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-023-00722-3
• PMID: 37735664
• Additional Information: Received: 17 April 2023; Accepted: 5 September 2023; First Online: 21 September 2023; : ; : The authors have no relevant interests to disclose.; : Ethical approval for this study was granted by the East of Scotland Research Ethics Committee (22-October-2019; Ref: 19/ES/0125). All the methods were conducted in accordance with relevant ethical guidelines and regulations.; : Informed consent was obtained from all participants included in this trial.; : Not applicable.