Structured Exercise after Adjuvant Chemotherapy for Colon Cancer.
Level 2 - randomized trial
Individual phase 3 multicenter randomized controlled trial
PubMed 40450658 · doi:10.1056/NEJMoa2502760
What was done
A phase 3 randomized controlled trial across 55 centers assigned 889 patients with resected colon cancer who had completed adjuvant chemotherapy to either a 3-year structured exercise program (445 patients) or health-education materials alone (444 patients). The primary end point was disease-free survival.
What was found
At a median follow-up of 7.9 years, disease-free survival was significantly longer in the exercise group than in the health-education group (hazard ratio 0.72; 95% CI, 0.55 to 0.94; P = 0.02). The 5-year disease-free survival was 80.3% with exercise versus 73.9% with health education (difference, 6.4 percentage points; 95% CI, 0.6 to 12.2). Overall survival also favored exercise (hazard ratio for death, 0.63; 95% CI, 0.43 to 0.94), with an 8-year overall survival of 90.3% versus 83.2% (difference, 7.1 percentage points; 95% CI, 1.8 to 12.3). Musculoskeletal adverse events were more common in the exercise group (18.5% vs. 11.5%).
Why it matters
This trial provides randomized evidence that a structured post-chemotherapy exercise program improves disease-free and overall survival in resected colon cancer.
Limits
The abstract does not provide details on exercise adherence, specific modality/intensity, or dropout rates. By design, participants could not be blinded. The study was restricted to patients who had successfully completed adjuvant chemotherapy, which may select for better baseline functional status, and the intervention increased musculoskeletal adverse events.
Cited by
- supports A study in the New England Journal of Medicine showed that exercise decreases the risk of colon cancer recurrence.