EXercise to prevent Anthracycline-based Cardio-Toxicity (EXACT 2.0) in women with breast cancer
Background: Cancer and cardiovascular disease are the leading causes of death for Canadian women. Many women will receive anthracyclines (AC) as treatment for breast cancer (BC) which can have cardiotoxic effects. Lifestyle inte1ventions, including aerobic exercise (AE), may offer an opportunity to prevent cardiotoxity when used in combination with, or in replacement of, pharmacological agents. Objective: To evaluate whether a 24-week, home-based AE program during AC-based chemotherapy will prevent cardiotoxicity in women with BC. Methods: Since 2019, women with BC receiving AC-based chemotherapy at St. Boniface Hospital have been recruited and randomized to either the control or AE group. Baseline patient demographics and cardiovascular risk factors were obtained. Cardiac function was assessed using trans thoracic echocardiography to quantify left ventricular ejection fraction (L VEF) and global longitudinal strain (GLS). Quality of life and cancer therapy related fatigue were assessed using the Functional Assessment for Cancer Therapy-Breast and Functional Assessment of Chronic Illness Therapy-Fatigue scales, respectively. Results: A total of 19 women were enrolled who were middle-aged and had few cardiac risk factors. The average adherence to AE was 93%. There was no significant difference between the control and AE groups at baseline and no adverse changes were observed between baseline and 6-month follow-up in either group for L VEF, GLS, or quality oflife factors. Conclusion: This pilot study supports that a 24-week, home-based AE program is feasible with high adherence. Further recruitment and future studies are required to determine whether home-based AE is cardioprotective in the setting of chemotherapy mediated cardiotoxicity.
breast cancer, anthracyclines (AC)