• Philipp Zimmer, Tobias Esser, Diana Lueftner, Florian Schuetz, Freerk T Baumann, Achim Rody, Andreas Schneeweiss, Andreas D Hartkopf, Thomas Decker, Christoph Uleer, Oliver J Stoetzer, Frank Foerster, Marcus Schmidt, Christoph Mundhenke, Karen Steindorf, Hans Tesch, Christian Jackisch, Thomas Fischer, Sven Hanson, Julia Kreuzeder, Gernot Guderian, Peter A Fasching, and Wilhelm Bloch.
• Institute for Sport and Sport Science, Division of Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany. philipp.zimmer@tu-dortmund.de.
• Bmc Med. 2024 Oct 8; 22 (1): 442442.

BackgroundIncreased levels of physical activity are associated with a reduction of breast cancer mortality, especially in postmenopausal women with positive hormone receptor status. So far, previous observational case-control and cohort studies have focused on associations between overall leisure time physical activity and survival of women with breast cancer in general.MethodsIn this multicenter prospective cohort study, conducted in Germany between 30th August 2012 to 29th December 2017, we investigated general physical activity in a homogenous sample of n = 1440 postmenopausal women with advanced (inoperable locally advanced or metastatic), hormone receptor-positive breast cancer receiving the same therapy (everolimus and exemestane). Self-reported physical activity was assessed using the Godin Leisure Time Exercise Questionnaire (GLTEQ) before and every 3 months during treatment. Participants were then classified into "active" and "insufficiently active" to screen their activity behavior the week prior to medical treatment. In addition, changes in physical activity patterns were assessed. Adjusted Cox regression analyses were performed for the activity categories to determine hazard ratios (HR). Besides progression-free survival (PFS), adverse events (AEs), QoL, and fatigue were assessed every 3 months until study termination.ResultsCompared to "insufficiently active" patients, "active" individuals indicated a significantly longer PFS (HR: 0.84 [0.74; 0.984], p = .0295). No significant differences were observed for changes of physical activity behavior. Patients who reported to be "active" at baseline revealed significantly fewer AEs compared to "insufficiently" active patients. In detail, both severe and non-severe AEs occurred less frequently in the "active" patients group. In line with that, QoL and fatigue were better in physical "active" patients compared to their insufficient active counterparts at the last post-baseline assessment. Participants who remained or become active indicated less AEs, a higher QoL, and reduced fatigue levels.ConclusionsPhysical activity behavior prior to medical treatment might have prognostic value in patients with advanced breast cancer in terms of extending the PFS. Moreover, physical activity before and during treatment may reduce treatment-related side effects and improve patients' QoL and fatigue.Trial RegistrationEUPAS9462. Registered 30th October 2012 "retrospectively registered."© 2024. The Author(s).

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