Accelerating precision exercise medicine in cancer patients using pooled individual patient data: POLARIS experience

Area of Science:

• Exercise oncology
• Cancer rehabilitation
• Precision medicine

Background:

• Numerous exercise oncology trials inform current recommendations for cancer patients.
• Exercise medicine for cancer can be tailored in type, dose, schedule, and timing.
• Precision exercise medicine requires understanding individual patient responses to interventions.

Purpose of the Study:

• Highlight the value of pooled individual patient data (IPD) analyses.
• Summarize findings from pooled IPD analyses on exercise effects in cancer patients.
• Provide guidance for advancing precision exercise medicine in oncology.

Main Methods:

• Utilized the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study infrastructure.
• Performed pooled analyses of IPD from multiple randomized controlled trials.
• Included IPD from 52 exercise trials in the current POLARIS database.

Main Results:

• Exercise interventions benefit physical fitness, fatigue, quality of life, cognition, sleep, anxiety, and depression in cancer patients.
• Exercise effects are modified by patient characteristics (e.g., baseline values, age, marital status, education).
• Intervention characteristics (e.g., supervision, specificity) also influence exercise effects.

Conclusions:

• Pooled IPD analyses are valuable for advancing precision exercise medicine in cancer care.
• Future research should focus on understudied populations, clinical outcomes, biomarkers, and machine learning for personalized treatment.
• Tailoring exercise interventions based on individual patient and intervention characteristics is key for optimal cancer rehabilitation.