1
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Mabudian L, Reding K, D'Agostino RB, Heiston EM, Bellissimo MP, Olson K, Ntim WO, Klepin HD, Dressler EV, Moore T, Jordan JH, O'Connell NS, Ladd A, Weaver KE, Ky B, Wagner LI, Hackney MH, Lesser GJ, Hundley WG. The relationship between body composition and left ventricular performance in women with breast, lymphoma, or sarcoma cancer. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2024; 10:34. [PMID: 38845066 PMCID: PMC11155055 DOI: 10.1186/s40959-024-00233-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/01/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND To understand how body composition in those with elevated body mass index impacts left ventricular function decline during cancer treatment, we determined the association between baseline body mass index (BMI), intra-abdominal adipose tissue (IAT) and subcutaneous adipose tissue (SAT) with baseline to 3-month left ventricular ejection fraction (LVEF) change among women receiving potentially cardiotoxic chemotherapy for breast cancer, lymphoma, or sarcoma. METHODS Women underwent potentially cardiotoxic chemotherapy, such as doxorubicin, cyclophosphamide, paclitaxel, and trastuzumab, for treatment of breast cancer, lymphoma, or sarcoma. We obtained magnetic resonance images (MRIs) of body composition and cardiac function prior to treatment, and then a repeat MRI for cardiac function assessment at three months into treatment. Analyses and assessment of abdominal adipose tissue volumes and LVEF outcomes were conducted by independent reviewers blinded to all patient identifiers. A general linear model was created to examine associations between adipose tissue depots, BMI, and 3-month LVEF change. RESULTS Women (n = 210) aged 56 ± 11 years with breast cancer, lymphoma, and sarcoma were enrolled (n = 195, 14, 1 respectively). Baseline BMI, IAT, and SAT fat were independently associated with 3-month LVEF declines (p = 0.001 to 0.025 for all). After adjusting for baseline cardiovascular disease risk factors, BMI, IAT, and SAT, BMI remained the only variable associated with 3-month LVEF decline (p = 0.047). CONCLUSIONS These results suggest that factors other than abdominal adipose tissue or traditional cardiovascular risk factors may contribute to 3-month declines in LVEF among women with elevated BMI receiving potentially cardiotoxic chemotherapy. Further investigation should be conducted on psychosocial stress, physical activity, sleep, or diet. TRIAL REGISTRATION DETECTIV_NCT01719562, WF99112, & WF97415-NCT02791581.
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Affiliation(s)
- Leila Mabudian
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University (VCU), PO Box 980335, Richmond, VA, USA
| | - Kerry Reding
- University of Washington, Behavioral Nursing and Health Systems, Seattle, WA, USA
| | - Ralph B D'Agostino
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Emily M Heiston
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University (VCU), PO Box 980335, Richmond, VA, USA
| | - Moriah P Bellissimo
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University (VCU), PO Box 980335, Richmond, VA, USA
| | - Kristine Olson
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University (VCU), PO Box 980335, Richmond, VA, USA
| | - William O Ntim
- UNC School of Medicine, Novant Health Campus, Novant Health Heart & Vascular Institute, Charlotte, NC, USA
| | - Heidi D Klepin
- Section On Hematology and Oncology, Department of Internal Medicine at Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Emily V Dressler
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Tonya Moore
- Section On Cardiovascular Medicine, Department of Internal Medicine at Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennifer H Jordan
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University (VCU), PO Box 980335, Richmond, VA, USA
- Department of Biomedical Engineering, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Nathaniel S O'Connell
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Amy Ladd
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University (VCU), PO Box 980335, Richmond, VA, USA
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Bonnie Ky
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Lynne I Wagner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Mary Helen Hackney
- Department of Hematology, Oncology, and Palliative Care, Virginia Commonwealth University, Massey Cancer Center, Richmond, VA, USA
| | - Glenn J Lesser
- Section On Hematology and Oncology, Department of Internal Medicine at Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - W Gregory Hundley
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University (VCU), PO Box 980335, Richmond, VA, USA.
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Cerulli C, Moretti E, Grazioli E, Emerenziani GP, Murri A, Tranchita E, Minganti C, Di Cagno A, Parisi A. Protective role of exercise on breast cancer-related osteoporosis in women undergoing aromatase inhibitors: A narrative review. Bone Rep 2024; 21:101756. [PMID: 38577250 PMCID: PMC10990716 DOI: 10.1016/j.bonr.2024.101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/19/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024] Open
Abstract
Hormone therapy following surgery reduces the risk of breast cancer (BC) recurrence and progression of hormone-sensitive BC, especially in postmenopausal women. Despite the antitumor efficacy of hormone therapy, particularly of aromatase inhibitors, they cause long-term side effects, mainly bone density reduction. Exercise can slow the rate of bone loss, which reduces the risk of fractures from osteoporosis, and could be an integrative treatment able to mitigate the BC treatment side effects positively impacting bone health. This narrative review aims to discuss studies on the effect of exercise on bone health in BC women undergoing aromatase inhibitors, highlighting the possible role of exercise as complementary to conventional therapies. Additionally, according to the literature revision, exercise practical applications to improve bone health in these patients are summarized.
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Affiliation(s)
- Claudia Cerulli
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Elisa Moretti
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Elisa Grazioli
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Gian Pietro Emerenziani
- Department of Experimental and Clinical Medicine, “Magna Græcia” University, Viale Europa, 88100 Catanzaro, Italy
| | - Arianna Murri
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Eliana Tranchita
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Carlo Minganti
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Alessandra Di Cagno
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
| | - Attilio Parisi
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis, 15, 00135 Rome, Italy
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3
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Moulton C, Murri A, Benotti G, Fantini C, Duranti G, Ceci R, Grazioli E, Cerulli C, Sgrò P, Rossi C, Magno S, Di Luigi L, Caporossi D, Parisi A, Dimauro I. The impact of physical activity on promoter-specific methylation of genes involved in the redox-status and disease progression: A longitudinal study on post-surgery female breast cancer patients undergoing medical treatment. Redox Biol 2024; 70:103033. [PMID: 38211440 PMCID: PMC10821067 DOI: 10.1016/j.redox.2024.103033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
Most anticancer treatments act on oxidative-stress pathways by producing reactive oxygen species (ROS) to kill cancer cells, commonly resulting in consequential drug-induced systemic cytotoxicity. Physical activity (PA) has arisen as an integrative cancer therapy, having positive health effects, including in redox-homeostasis. Here, we investigated the impact of an online supervised PA program on promoter-specific DNA methylation, and corresponding gene expression/activity, in 3 antioxidants- (SOD1, SOD2, and CAT) and 3 breast cancer (BC)-related genes (BRCA1, L3MBTL1 and RASSF1A) in a population-based sample of women diagnosed with primary BC, undergoing medical treatment. We further examined mechanisms involved in methylating and demethylating pathways, predicted biological pathways and interactions of exercise-modulated molecules, and the functional relevance of modulated antioxidant markers on parameters related to aerobic capacity/endurance, physical fatigue and quality of life (QoL). PA maintained levels of SOD activity in blood plasma, and at the cellular level significantly increased SOD2 mRNA (≈+77 %), contrary to their depletion due to medical treatment. This change was inversely correlated with DNA methylation in SOD2 promoter (≈-20 %). Similarly, we found a significant effect of PA only on L3MBTL1 promoter methylation (≈-25 %), which was inversely correlated with its mRNA (≈+43 %). Finally, PA increased TET1 mRNA levels (≈+15 %) and decreased expression of DNMT3B mRNA (≈-28 %). Our results suggest that PA-modulated DNA methylation affects several signalling pathways/biological activities involved in the cellular oxidative stress response, chromatin organization/regulation, antioxidant activity and DNA/protein binding. These changes may positively impact clinical outcomes and improve the response to cancer treatment in post-surgery BC patients.
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Affiliation(s)
- Chantalle Moulton
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Arianna Murri
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Gianmarco Benotti
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Cristina Fantini
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Guglielmo Duranti
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Roberta Ceci
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Elisa Grazioli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Claudia Cerulli
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Paolo Sgrò
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Cristina Rossi
- Center for Integrative Oncology, Fondazione Policlinico Universitario A.Gemelli IRCCS, Italy
| | - Stefano Magno
- Center for Integrative Oncology, Fondazione Policlinico Universitario A.Gemelli IRCCS, Italy
| | - Luigi Di Luigi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Attilio Parisi
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy.
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4
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Caporossi D, Dimauro I. Exercise-induced redox modulation as a mediator of DNA methylation in health maintenance and disease prevention. Free Radic Biol Med 2024; 213:113-122. [PMID: 38242245 DOI: 10.1016/j.freeradbiomed.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/21/2024]
Abstract
The evidence for physical activity (PA) as a major public health preventive approach and a potent medical therapy has increased exponentially in the last decades. The biomolecular mechanisms supporting the associations between PA and/or structured exercise training with health maintenance and disease prevention are not completely characterized. However, increasing evidence pointed out the role of epigenetic modifications in exercise adaptation and health-enhancing PA throughout life, DNA methylation being the most intensely studied epigenetic modification induced by acute and chronic exercise. The current data on the modulation of DNA methylation determined by physically active behavior or exercise interventions points out genes related to energy regulation, mitochondrial function, and biosynthesis, as well as muscle regeneration, calcium signaling pathways, and brain plasticity, all consistent with the known exercise-induced redox signaling and/or reactive oxygen species (ROS) unbalance. Thus, the main focus of this review is to discuss the role of ROS and redox-signaling on DNA methylation profile and its impact on exercise-induced health benefits in humans.
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Affiliation(s)
- Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis 15, Rome, 00135, Italy.
| | - Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis 15, Rome, 00135, Italy
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Abreu A. Best timing for exercise in breast cancer patients initiating chemotherapy: what is the answer? Eur Heart J 2023; 44:4890-4892. [PMID: 37178153 DOI: 10.1093/eurheartj/ehad136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Affiliation(s)
- Ana Abreu
- Cardiology Department, Cardiovascular Rehabilitation Unit, Centro Hospitalar Universitário Lisboa Norte, CAML, Instituto Saúde Ambiental ISAMB, TERRA, IMPSP, CCUL@RISE, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, Portugal
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6
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Moulton C, Grazioli E, Antinozzi C, Fantini C, Cerulli C, Murri A, Duranti G, Ceci R, Vulpiani MC, Pellegrini P, Nusca SM, Cavaliere F, Fabbri S, Sgrò P, Di Luigi L, Caporossi D, Parisi A, Dimauro I. Online Home-Based Physical Activity Counteracts Changes of Redox-Status Biomarkers and Fitness Profiles during Treatment Programs in Postsurgery Female Breast Cancer Patients. Antioxidants (Basel) 2023; 12:antiox12051138. [PMID: 37238004 DOI: 10.3390/antiox12051138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/06/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Breast cancer (BC) is one of the most commonly diagnosed types of cancer in women. Oxidative stress may contribute to cancer etiology through several mechanisms. A large body of evidence indicates that physical activity (PA) has positive effects on different aspects of BC evolution, including mitigation of negative effects induced by medical treatment. With the aim to verify the capacity of PA to counteract negative effects of BC treatment on systemic redox homeostasis in postsurgery female BC patients, we have examined the modulation of circulating levels of oxidative stress and inflammation markers. Moreover, we evaluated the impacts on physical fitness and mental well-being by measuring functional parameters, body mass index, body composition, health-related quality of life (QoL), and fatigue. Our investigation revealed that PA was effective in maintaining plasma levels of superoxide dismutase (SOD) activity and tGSH, as well as peripheral blood mononuclear cells' (PBMCs) mRNA levels of SOD1 and heat-shock protein 27. Moreover, we found a significant decrease in plasma interleukin-6 (≈0.57 ± 0.23-fold change, p < 0.05) and increases in both interleukin-10 (≈1.15 ± 0.35-fold change, p < 0.05) and PBMCs' mRNA level of SOD2 (≈1.87 ± 0.36-fold change, p < 0.05). Finally, PA improves functional parameters (6 min walking test, ≈+6.50%, p < 0.01; Borg, ≈-58.18%, p < 0.01; sit-and-reach, ≈+250.00%, p < 0.01; scratch right, ≈-24.12%, and left, ≈-18.81%, p < 0.01) and body composition (free fat mass, ≈+2.80%, p < 0.05; fat mass, ≈-6.93%, p < 0.05) as well as the QoL (physical function, ≈+5.78%, p < 0.05) and fatigue (cognitive fatigue, ≈-60%, p < 0.05) parameters. These results suggest that a specific PA program not only is effective in improving functional and anthropometric parameters but may also activate cellular responses through a multitude of actions in postsurgery BC patients undergoing adjuvant therapy. These may include modulation of gene expression and protein activity and impacting several signaling pathways/biological activities involved in tumor-cell growth; metastasis; and inflammation, as well as moderating distress symptoms known to negatively affect QoL.
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Affiliation(s)
- Chantalle Moulton
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Elisa Grazioli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Cristina Antinozzi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Cristina Fantini
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Claudia Cerulli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Arianna Murri
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Guglielmo Duranti
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Roberta Ceci
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Maria Chiara Vulpiani
- Department of Medical-Surgical and Translational Medicine Sciences, La Sapienza University of Rome, 00185 Rome, Italy
| | - Patrizia Pellegrini
- Department of Medical-Surgical and Translational Medicine Sciences, La Sapienza University of Rome, 00185 Rome, Italy
| | - Sveva Maria Nusca
- Department of Medical-Surgical and Translational Medicine Sciences, La Sapienza University of Rome, 00185 Rome, Italy
| | - Francesco Cavaliere
- Unit of Breast Surgery, Center of Breast of Belcolle Hospital, 01100 Viterbo, Italy
| | - Simona Fabbri
- Unit of Breast Surgery, Center of Breast of Belcolle Hospital, 01100 Viterbo, Italy
| | - Paolo Sgrò
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Luigi Di Luigi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Attilio Parisi
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
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7
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Tsai YL, Chuang YC, Chen CP, Lee YC, Cheng YY, Ou-Yang LJ. Feasibility of Aerobic Exercise Training to Mitigate Cardiotoxicity of Breast Cancer Therapy: A Systematic Review and Meta-Analysis. Clin Breast Cancer 2023:S1526-8209(23)00094-0. [PMID: 37286435 DOI: 10.1016/j.clbc.2023.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 04/16/2023] [Accepted: 04/29/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Current anticancer treatments for breast cancer (BC) may cause cardiotoxicity. This study aimed to investigate the effectiveness of aerobic exercise in mitigating cardiotoxicity caused by BC therapy. MATERIALS AND METHODS PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database were searched until February 7, 2023. Clinical trials investigating the effectiveness of exercise training, including aerobic exercise, in BC patients receiving treatments that could cause cardiotoxicity were eligible. Outcome measures included cardiorespiratory fitness (CRF) (peak oxygen consumption, VO2peak), left ventricular ejection fraction, and peak oxygen pulse. Intergroup differences were determined by standard mean differences (SMD) and 95% confidence intervals (CIs). Trial sequential analysis (TSA) was utilized to ensure whether the current evidence was conclusive. RESULTS Sixteen trials involving 876 participants were included. Aerobic exercise significantly improved CRF measured by VO2peak in mL/kg/min (SMD 1.79, 95% CI 0.99-2.59) when compared to usual care. This result was confirmed through TSA. Subgroup analyses revealed that aerobic exercise given during BC therapy significantly improved VO2peak (SMD 1.84, 95% CI 0.74-2.94). Exercise prescriptions at a frequency of up to 3 times per week, an intensity of moderate to vigorous, and a >30-minute session length also improved VO2peak. CONCLUSION Aerobic exercise is effective in improving CRF when compared to usual care. Exercise performed up to 3 times per week, at a moderate-to-vigorous intensity, and having a session length >30 minutes is considered effective. Future high-quality research is needed to determine the effectiveness of exercise intervention in preventing cardiotoxicity caused by BC therapy.
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Affiliation(s)
- Yu-Lin Tsai
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ya-Chi Chuang
- Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Carl Pc Chen
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chun Lee
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan; Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
| | - Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Liang-Jun Ou-Yang
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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8
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Nevins S, McLoughlin CD, Oliveros A, Stein JB, Rashid MA, Hou Y, Jang MH, Lee KB. Nanotechnology Approaches for Prevention and Treatment of Chemotherapy-Induced Neurotoxicity, Neuropathy, and Cardiomyopathy in Breast and Ovarian Cancer Survivors. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2300744. [PMID: 37058079 PMCID: PMC10576016 DOI: 10.1002/smll.202300744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/05/2023] [Indexed: 06/19/2023]
Abstract
Nanotechnology has emerged as a promising approach for the targeted delivery of therapeutic agents while improving their efficacy and safety. As a result, nanomaterial development for the selective targeting of cancers, with the possibility of treating off-target, detrimental sequelae caused by chemotherapy, is an important area of research. Breast and ovarian cancer are among the most common cancer types in women, and chemotherapy is an essential treatment modality for these diseases. However, chemotherapy-induced neurotoxicity, neuropathy, and cardiomyopathy are common side effects that can affect breast and ovarian cancer survivors quality of life. Therefore, there is an urgent need to develop effective prevention and treatment strategies for these adverse effects. Nanoparticles (NPs) have extreme potential for enhancing therapeutic efficacy but require continued research to elucidate beneficial interventions for women cancer survivors. In short, nanotechnology-based approaches have emerged as promising strategies for preventing and treating chemotherapy-induced neurotoxicity, neuropathy, and cardiomyopathy. NP-based drug delivery systems and therapeutics have shown potential for reducing the side effects of chemotherapeutics while improving drug efficacy. In this article, the latest nanotechnology approaches and their potential for the prevention and treatment of chemotherapy-induced neurotoxicity, neuropathy, and cardiomyopathy in breast and ovarian cancer survivors are discussed.
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Affiliation(s)
- Sarah Nevins
- Department of Chemistry and Chemical Biology, Rutgers
University, the State University of New Jersey, 123 Bevier Road, Piscataway, NJ
08854, U.S.A
| | - Callan D. McLoughlin
- Department of Chemistry and Chemical Biology, Rutgers
University, the State University of New Jersey, 123 Bevier Road, Piscataway, NJ
08854, U.S.A
| | - Alfredo Oliveros
- Department of Neurosurgery, Robert Wood Johnson Medical
School, Rutgers University, the State University of New Jersey, 661 Hoes Ln W,
Piscataway, NJ, 08854, U.S.A
| | - Joshua B. Stein
- Department of Chemistry and Chemical Biology, Rutgers
University, the State University of New Jersey, 123 Bevier Road, Piscataway, NJ
08854, U.S.A
| | - Mohammad Abdur Rashid
- Department of Neurosurgery, Robert Wood Johnson Medical
School, Rutgers University, the State University of New Jersey, 661 Hoes Ln W,
Piscataway, NJ, 08854, U.S.A
| | - Yannan Hou
- Department of Chemistry and Chemical Biology, Rutgers
University, the State University of New Jersey, 123 Bevier Road, Piscataway, NJ
08854, U.S.A
| | - Mi-Hyeon Jang
- Department of Neurosurgery, Robert Wood Johnson Medical
School, Rutgers University, the State University of New Jersey, 661 Hoes Ln W,
Piscataway, NJ, 08854, U.S.A
| | - Ki-Bum Lee
- Department of Chemistry and Chemical Biology, Rutgers
University, the State University of New Jersey, 123 Bevier Road, Piscataway, NJ
08854, U.S.A
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9
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"OPERATION PHALCO"-Adapted Physical Activity for Breast Cancer Survivors: Is It Time for a Multidisciplinary Approach? Cancers (Basel) 2022; 15:cancers15010034. [PMID: 36612031 PMCID: PMC9817922 DOI: 10.3390/cancers15010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
The international literature emphasizes the importance of physical activity (PA) in the first steps after cancer surgery. The regular practice of physical exercise causes positive adaptations on several functional capacities, with positive consequences on patients' quality of life. This project aims to evaluate the effect of a post-operative training protocol, structured by taking into account both cancer-related issues and the presence of comorbidities, on functional capacities and quality of life of breast cancer survivors. Therefore, it was necessary to create a synergy between oncologists (referring physicians), sport medicine physicians (risk stratification and exercise prescription) and kinesiologists (trainers). Thirty-five post-surgery BC patients decided on a voluntary basis to attend an online Adapted PA (APA) protocol for 4 months, twice a week (APA Group) or Usual Care Group (UC Group). Functional capacity of the APA Group significantly increased, by 13.1% (p = 0.000), whereas perceived exertion decreased by 19.7% (p = 0.020). In the same group, the general health evaluated through the questionnaire EORTC-QLQ-C30 increased (p = 0.050). No differences were found in the UC Group. Operation Phalco, creating a network between oncologists, sports medicine physicians and kinesiologists, confirms the importance of structuring a post-operative path where APA should be included as early as possible in the cancer patient care.
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Kourek C, Touloupaki M, Rempakos A, Loritis K, Tsougkos E, Paraskevaidis I, Briasoulis A. Cardioprotective Strategies from Cardiotoxicity in Cancer Patients: A Comprehensive Review. J Cardiovasc Dev Dis 2022; 9:jcdd9080259. [PMID: 36005423 PMCID: PMC9409997 DOI: 10.3390/jcdd9080259] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 12/02/2022] Open
Abstract
Cardiotoxicity is a significant complication of chemotherapeutic agents in cancer patients. Cardiovascular incidents including LV dysfunction, heart failure (HF), severe arrhythmias, arterial hypertension, and death are associated with high morbidity and mortality. Risk stratification of cancer patients prior to initiation of chemotherapy is crucial, especially in high-risk patients for cardiotoxicity. The early identification and management of potential risk factors for cardiovascular side effects seems to contribute to the prevention or minimization of cardiotoxicity. Screening of cancer patients includes biomarkers such as cTnI and natriuretic peptide and imaging measurements such as LV function, global longitudinal strain, and cardiac MRI. Cardioprotective strategies have been investigated over the last two decades. These strategies for either primary or secondary prevention include medical therapy such as ACE inhibitors, ARBs, b-blockers, aldosterone antagonists, statins and dexrazoxane, physical therapy, and reduction of chemotherapeutic dosages. However, data regarding dosages, duration of medical therapy, and potential interactions with chemotherapeutic agents are still limited. Collaboration among oncologists, cardiologists, and cardio-oncologists could establish management cardioprotective strategies and approved follow-up protocols in patients with cancer receiving chemotherapy.
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Affiliation(s)
- Christos Kourek
- Medical School of Athens, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Athanasios Rempakos
- Medical School of Athens, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Loritis
- Medical School of Athens, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Elias Tsougkos
- Department of Cardiology, Hygeia Hospital, 15123 Athens, Greece
| | - Ioannis Paraskevaidis
- Medical School of Athens, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Cardiology, Hygeia Hospital, 15123 Athens, Greece
| | - Alexandros Briasoulis
- Medical School of Athens, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa, Iowa City, IA 52242, USA
- Correspondence:
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Caru M, Curnier D. The pediatric oncology exercise field speeds up to address important issues regarding chemotherapy-related cardiotoxicity. Front Pediatr 2022; 10:998337. [PMID: 36313894 PMCID: PMC9614334 DOI: 10.3389/fped.2022.998337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/28/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Maxime Caru
- Department of Pediatric, Division of Hematology and Oncology, Penn State College of Medicine, Hershey, PA, United States.,Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Daniel Curnier
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Division of Pediatric Hematology and Oncology, Sainte-Justine University Health Center, Research Center, Montreal, QC, Canada
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