Reducing the Rate of Treatment Disruptions Through a Digital Structured Exercise and Mind-Body Program During...

Treatment disruptions and discontinuations during systemic cancer therapy are common and can compromise treatment delivery and outcomes. Structured exercise and mind-body interventions improve cancer-related symptoms, but their impact on treatment disruptions and discontinuations remains unclear. This secondary analysis of the IMPROVE trial evaluated whether participation in Integrative Medicine at Home (IM@Home), a digital multimodal mind-body and structured exercise program, was associated with differences in treatment discontinuation and related treatment disruption outcomes among patients undergoing systemic therapy.

A total of 127 adults with solid tumors were randomized to IM@Home (n = 64) or enhanced usual care (EUC; n = 63) for 12 weeks. Treatment discontinuation, dose delays, dose reductions, and overall treatment disruptions were compared between arms using chi-square tests and regression models adjusted for cancer type and disease stage.

In unadjusted analyses, treatment discontinuation occurred less frequently in the IM@Home group compared with EUC (9.4% vs. 22.6%; p = 0.043), but this association was attenuated after adjustment for cancer type and disease stage (aOR 0.41, 95% CI 0.13-1.17; p = 0.105). The proportion of patients experiencing any treatment disruption, as well as rates of dose delays and dose reductions, did not differ significantly between groups (p = 0.16, p = 0.18, and p = 0.85, respectively). In contrast, IM@Home participants experienced fewer treatment disruption events per patient (adjusted RR 0.58, 95% CI 0.35-0.96; p = 0.036).

These exploratory findings suggest that digital structured exercise and mind-body programs may help mitigate treatment interruptions during systemic cancer therapy and should be explored further in an adequately powered prospective trial to confirm these promising findings.