The dose-response effect of aerobic exercise on inflammation in colon cancer survivors

Justin C Brown; Stephanie L E Compton; Jeffrey A Meyerhardt; Guillaume Spielmann; Shengping Yang

doi:10.3389/fonc.2023.1257767

The dose-response effect of aerobic exercise on inflammation in colon cancer survivors

Front Oncol. 2023 Dec 12:13:1257767. doi: 10.3389/fonc.2023.1257767. eCollection 2023.

Authors

Justin C Brown^{1

2

3

4}, Stephanie L E Compton¹, Jeffrey A Meyerhardt⁵, Guillaume Spielmann⁶, Shengping Yang¹

Affiliations

¹ Pennington Biomedical Research Center, Baton Rouge, LA, United States.
² Louisiana State University (LSU) Health Sciences Center New Orleans School of Medicine, New Orleans, LA, United States.
³ Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, United States.
⁴ Louisiana Cancer Research Center, New Orleans, LA, United States.
⁵ Dana-Farber Cancer Institute, Boston, MA, United States.
⁶ School of Kinesiology, College of Human Sciences & Education, Louisiana State University, Baton Rouge, LA, United States.

Abstract

Background: Physical activity after surgical resection for colon cancer is associated with significantly longer disease-free survival. Inflammation is hypothesized to mediate the association between physical activity and disease-free survival in colon cancer.

Methods: In this exploratory analysis of a randomized dose-response trial, 39 colon cancer survivors who completed standard therapy were stratified by cancer stage and randomized in a 1:1:1 ratio to one of three treatment groups for 24 weeks of usual-care control, 150 min/wk of moderate-intensity aerobic exercise (low-dose), or 300 min/wk of moderate-intensity aerobic exercise (high-dose). Inflammation outcomes included high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL6), and soluble tumor necrosis factor-alpha receptor 2 (sTNFαR2). Mixed models for repeated measures were used to test the hypothesis that exercise was associated with dose-response reductions in inflammation; exploratory analyses examined treatment effects by cancer stage.

Results: In the overall population, aerobic exercise was not associated with dose-response reductions in hs-CRP, IL6, or sTNFαR2. Cancer stage modified the association between randomized group and hs-CRP (P=0.022) and IL6 (P<0.001) but not sTNFαR2 (P=0.39). In stage I-II disease, compared to control, exercise was not associated with inflammation outcomes. In stage III disease, compared to control, low-dose exercise reduced hs-CRP: -35.4% (95% CI: -70.1, -0.7) and IL6: -29.6% (95% CI: -58.4, -0.8) but not sTNFαR2: 2.7% (95% CI: sTNFαR2: -15.7, 21.1); high-dose exercise was not associated with inflammation outcomes in stage III disease.

Conclusion: This exploratory analysis offers preliminary data to support the hypothesis that inflammation may mediate the association between physical activity and disease-free survival in colon cancer.

Clinical trial registration: clinicaltrials.gov, identifier NCT02250053.

Keywords: C-reactive protein; biomarkers; dose-response; interleukins; tumor necrosis factors.

Associated data

ClinicalTrials.gov/NCT02250053

Abstract

Associated data

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