Effects and moderators of exercise medicine on cardiometabolic outcomes in men with prostate cancer previously or currently undergoing androgen deprivation therapy: An individual patient data meta-analysis

Pedro Lopez; Robert U Newton; Dennis R Taaffe; Kerri Winters-Stone; Laurien M Buffart; Daniel A Galvão

doi:10.1016/j.critrevonc.2023.103995

Effects and moderators of exercise medicine on cardiometabolic outcomes in men with prostate cancer previously or currently undergoing androgen deprivation therapy: An individual patient data meta-analysis

Crit Rev Oncol Hematol. 2023 Jun:186:103995. doi: 10.1016/j.critrevonc.2023.103995. Epub 2023 Apr 18.

Authors

Pedro Lopez¹, Robert U Newton², Dennis R Taaffe³, Kerri Winters-Stone⁴, Laurien M Buffart⁵, Daniel A Galvão³

Affiliations

¹ Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia.
² Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
³ Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
⁴ Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA; Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands.
⁵ Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia; Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands. Electronic address: Laurien.Buffart@radboudumc.nl.

PMID: 37080399
DOI: 10.1016/j.critrevonc.2023.103995

Abstract

Purpose: To examine the effects and moderators of exercise effects on cardiometabolic outcomes in men with prostate cancer previously or currently undergoing androgen deprivation therapy (ADT).

Results: Seven trials including 560 patients were examined. Exercise resulted in significant effects on whole-body and regional fat mass (P ≤ 0.001). For whole-body fat mass, significant exercise effects were observed in patients who were unmarried (-1.4 kg, P < 0.05) and who presented with higher fat mass levels (-1.0 kg, P < 0.05). For diastolic blood pressure and low-density lipoprotein (LDL), younger (-4.7 mmHg, P < 0.05) and older patients (-0.2 mmol.l^-1, P < 0.10) achieved greater effects, respectively. Regarding high-density lipoprotein (HDL), patients undertaking ADT + prostatectomy + radiotherapy derived significant exercise effects (0.3 mmol.l^-1, P < 0.05).

Conclusions: Exercise effectively reduces fat mass across subgroups of men undergoing or following ADT with different characteristics. For diastolic blood pressure, HDL and LDL, groups based on age and treatment history could be specifically targeted with exercise medicine.

Keywords: Blood pressure; Exercise; Fat mass; Lipid profile; Moderators; Prostate cancer.

Publication types

Meta-Analysis
Review

MeSH terms

Androgen Antagonists / adverse effects
Androgens
Body Composition / physiology
Cardiovascular Diseases* / chemically induced
Humans
Male
Prostatic Neoplasms* / drug therapy

Substances

Androgen Antagonists
Androgens