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Effects of aerobic exercise training in anemic cancer patients receiving darbepoetin alfa: a randomized controlled trial.

AbstractBACKGROUND:
Anemia in patients with solid tumors is a common problem that is associated with impaired exercise capacity, increased fatigue, and lower quality of life (QoL). Erythropoiesis-stimulating agents (ESAs) have been shown to improve these outcomes; however, it is unknown if additional benefits can be achieved with aerobic exercise training.
METHODS:
We conducted a single-center, prospective, randomized, controlled trial in 55 mild-to-moderately anemic patients with solid tumors. Patients were randomized to either darbepoetin alfa alone (DAL, n = 29) or darbepoetin alfa plus aerobic exercise training (DEX; n = 26). The DEX group performed aerobic exercise training three times per week at 60%-100% of baseline exercise capacity for 12 weeks. The primary endpoint was QoL assessed by the Functional Assessment of Cancer Therapy-Anemia scale. Secondary endpoints were fatigue, cardiorespiratory fitness (VO(2peak)), hemoglobin (Hb) response, and darbepoetin alfa dosing.
RESULTS:
Intention-to-treat analyses indicated significant improvements in QoL and fatigue in both groups over time but there were no between-group differences. The DEX group had a significantly greater VO(2peak) than the DAL group (mean group difference, +3.0 ml/kg per minute; 95% confidence interval, 1.2-4.7; p = .001) and there were borderline significant differences in favor of the DEX group for Hb response and darbepoetin alfa dosing.
CONCLUSIONS:
Aerobic exercise training did not improve QoL or fatigue beyond the established benefits of DAL but it did result in favorable improvements in exercise capacity and a more rapid Hb response with lower dosing requirements. Our results may be useful to clinicians despite the more recent restrictions on the indications for ESAs.
AuthorsKerry S Courneya, Lee W Jones, Carolyn J Peddle, Christopher M Sellar, Tony Reiman, Anil A Joy, Neil Chua, Linda Tkachuk, John R Mackey
JournalThe oncologist (Oncologist) Vol. 13 Issue 9 Pg. 1012-20 (Sep 2008) ISSN: 1549-490X [Electronic] England
PMID18779540 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Erythropoietin
  • Darbepoetin alfa
Topics
  • Adult
  • Aged
  • Anemia (blood, drug therapy, physiopathology, therapy)
  • Darbepoetin alfa
  • Double-Blind Method
  • Erythropoietin (adverse effects, analogs & derivatives, therapeutic use)
  • Exercise
  • Exercise Therapy (methods)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms (blood, complications)
  • Quality of Life
  • Surveys and Questionnaires
  • Treatment Outcome

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