Exercise-based rehabilitation for breast cancer women with chemotoxicity: Pilot results

Background: Cancer therapeutics have significantly improved the life expectancy of breast cancer patients Unfortunately, effectiveness comes sometimes at the cost of cardiac dysfunction and heart failure (HF) Rehabilitation is known to be beneficial in cancer patients and HF patients We hypothesized that women with cancer therapeutics-related cardiac dysfunction (CTRCD) could benefit from such programs Methods: Women with a history of breast cancer and CTRCD were invited to engage in a pilot program combining high-intensity interval training (HIIT) and resistance training CTRCD was defined as a decrease in the left ventricle ejection fraction (LVEF) of >10 percentage points, to a value <53% We focused on HIIT prescription to optimize time and effects Volunteers were allocated for exercise training (ET) or Usual Care (UC) in a 1:1 ratio in a cross-over design (12 weeks each phase) The training program consisted of aerobic training combined with resistance training, 3 times a week for 12 weeks The aerobic part was tailored based on the maximal cardiorespiratory test Each session (ergocycle) started with a 5-minute warm-up (50W) followed by two to three 10-minute HIIT periods whose intensity was gradually increased up to 80-90% of peak power output (PPO) alternating with low-intensity recovery periods Echocardiographic, exercise and anthropometric parameters were analyzed before and after each phase Preliminary results were analyzed using Cohen's D effect size Results: Recruitment started in July 2018 In the first year, 51 patients fulfilled the criteria, 34 were directly contacted, from which 25 promptly declined the invitation (majorly for transportation issues and lack of time) Nine patients started our program, 5 completed the full program (usual care + exercise phases) Significant benefits were observed for PPO (d=0 4 ET vs baseline);%VO2max (d=0 39 ET vs baseline;d=0 42 ET vs UC);and LVEF (d=0 54 ET vs baseline) Anthropometric parameter did change over time (d= 0 02-0 20) Conclusion: For patients that were able to attend our program, an interesting effect was observed for exercise capacity and LVEF However, considering not only the unexpectedly low recruitment rate (mostly because patients had issues to engage themselves in this center-based program) but also the current COVID-19 situation, we are currently looking for moving to a hybrid strategy, based on telemedicine, where patients will be able to perform out-of-centre exercise training