Walking dose required to achieve a clinically meaningful reduction in cancer-related fatigue among patients with breast cancer receiving chemotherapy: A URCC NCORP nationwide prospective cohort study

Publication Title

ASCO

Document Type

Abstract

Publication Date

6-2024

Keywords

oregon; chiles

Abstract

Background:Exercise is recommended by ASCO as a treatment for cancer-related fatigue (CRF) - one of the most pervasive toxicities patients with breast cancer experience. Current oncology guidelines recommend aerobic exercise (e.g., walking) at a weekly dose of 150 minutes of moderate intensity or 75 minutes of vigorous intensity. While these recommendations exist and are effective for treating CRF, patients with breast cancer struggle to achieve these levels of exercise, especially at a vigorous intensity during chemotherapy. The purpose of this study was to determine the doses of low and moderate intensity walking required to elicit a clinically meaningful reduction in CRF.Methods:As part of a nationwide prospective cohort study, 580 female breast cancer patients (stage I-IIIC; receiving chemotherapy) were recruited from 19 University of Rochester Cancer Center NCI Community Oncology Research Program (URCC NCORP) Research Base locations. CRF (Multidimensional Fatigue Symptom Inventory) and exercise dose (i.e., walking via ACLS Physical Activity Measure) were measured at pre-chemotherapy, 1-month post-chemotherapy, and 6-months post-chemotherapy. Exercise dose was measured in METs (energy expenditure normalized for body weight and time; 1 MET = 1 kcal/kg/hr) and converted into walking time (minutes) and intensity (mph). A low-intensity walking pace is < 2.5mph (< 3 METs), and a moderate-intensity walking pace is 2.6-4.5mph (3.1-6 METs).Results:Pre-chemotherapy, patients with breast cancer averaged walking 40-60 minutes/week at a low intensity or 20-38 minutes/week at a moderate intensity (median: 2.0 MET hrs/wk). Linear mixed modeling demonstrated a higher amount of walking significantly predicts lower CRF at all three time points (β: -0.26, SE: 0.08; p < 0.001). Logistic regression identified that patients who increase their walking by 111-162 minutes at a low-intensity pace or 54-108 minutes at a moderate-intensity pace (i.e., 1 SD) are 43% more likely to experience a clinically meaningful reduction in CRF (- 4.5 MFSI total) from pre-chemotherapy to 1-month post-chemotherapy (SD: 5.4 MET hrs/wk; OR: 1.43, 95% CI: 1.19-1.72; p < 0.001).Conclusions:Over the course of chemotherapy, patients with breast cancer who can increase their walking at a low intensity pace (< 2.5 mph) up to 151-222 min/wk or at a moderate intensity pace (2.6-4.5 mph) up to 74-146 min/wk are 43% more likely to have clinically meaningful lower levels of CRF post-chemotherapy.

Area of Special Interest

Cancer

Specialty/Research Institute

Oncology

Comments

Lindsey Jean Mattick, Po-Ju Lin, Karen Michelle Mustian, Luke Joseph Peppone, Umang Gada, Stephen Rajan Samuel, Viktor Clark, Sule Yilmaz, Jeremy McGuire, Alison Katherine Conlin, Lora Rose Weiselberg, Jerry W. Mitchell, Michelle Christine Janelsins

DOI

10.1200/JCO.2024.42.16_suppl.12008

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