Association between physical activity and neoadjuvant chemotherapy completion and pathologic complete response in primary breast cancer: the CANTO study

Regular physical activity is associated with improved symptom control in patients with breast cancer but its association with chemotherapy completion or response is unclear.

Using a prospective design, 1075 breast cancer patients receiving neoadjuvant chemotherapy between March 2012 and February 2017 were studied. Physical activity was assessed using the Global

Physical Activity Questionnaire [GPAQ-16], quantified in standardised MET-h/wk. Chemotherapy completion was defined as the proportion of patients completing planned treatment course,

requiring dose reduction, or requiring dose delay. Response was evaluated by pathologic complete response (pCR). Associations between physical activity and primary outcomes were assessed

using multivariable logistic regression models.

There was no differences between any chemotherapy completion outcome on the basis of physical activity classification. The percent of patients not completing planned treatment was 5.7% for

≦0.33 MET-h/wk, compared with 6.8% for 0.34–16.65 MET-h/wk, and 4.6% for ≥16.6 MET-h/wk (p = 0.52). No significant relationships were observed between physical activity dose classification

and pCR for the overall cohort or upon stratification by clinical subtype.

Future studies are required to further investigate the relationship between pre-treatment levels of physical activity and function on treatment completion and response in breast and other

cancer populations.

An interim analysis from this study was presented at the San Antonio Breast Cancer Symposium 2018, Dec 4–8, San Antonio, TX.

CANTO is funded by Agence Nationale de la Recherche (ANR-10-COHO-0004). IV-L received support from Odyssea, Foundation Gustave Roussy, and CCR17483507 Career Catalyst Research grant. ADM

received support from Susan G. Komen, Clinical Research Fellowship from ESMO. LWJ is supported in part by funding from the National Cancer Institute, AKTIV Against Cancer, the KavliTrust,

and the Memorial Sloan Kettering Cancer Center Support Grant/Core Grant (P30 CA008748).

These authors contributed equally: Ines Vaz-Luis, Lee W Jones.

INSERM U 981 - Prédicteurs moléculaires et nouvelles cibles en oncologie, Institut Gustave Roussy, Villejuif, France

Antonio Di Meglio, Arnauld S. Gbenou, Mayssam El Mouhebb, Andre Fabrice & Ines Vaz-Luis

Memorial Sloan Kettering Cancer Center, New York City, NY, USA

INSERM U1018 CESP, Service de Biostatistique et d’Epidemiologie, Institut Gustave Roussy, Villejuif, France

Medical Oncology Department, Institut Gustave Roussy, Villejuif, France

JLB: Wrote the paper. ADM, ASG, MEM: Conceived and designed the analysis and performed the analysis. NMI: Conceived and designed the analysis. SM, PC, FL, CC, AL, OT, LV, CJ, IH, SE, A-LM,

PA, AF: Collected the data. IV-L, LWJ: Conceived and designed the analysis and wrote the paper.

LWJ owns stock in Pacylex, Inc. and Illumisonics, Inc. IV-L reports personal fees from AstraZeneca, Kephren, Amgen, and Novartis. ADM reports personal fees from Thermo Fisher and grants from

European Society for Medical Oncology (ESMO), fellowship support, outside the submitted work.

Informed consent was obtained from all patients prior to study participation at each institution.

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