Table 1 Characteristics of the included studies
Study ID | Study Design | Country | Total Participants | Intervention | Chemotherapeutic drug | Cancer Type and Stage | Exercise Adherence | Primary Outcome | Follow-up duration | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | Intervention duration (Weeks) | Intervention frequency (Sessions per week) | Session duration (min) | Exercise intensity | Control | |||||||||
Bolam et al.2019 [25] (OptiTrain) | RCT | Sweden | 260 | 1) Resistance and high-intensity interval training (RT-HIIT) OR 2) Moderate-intensity aerobic and high-intensity interval training (AT–HIIT) | 16 | 2 | 60 | Moderate-to-high–intensity exercise | Usual care | Anthracyclines, taxanes, or a combination of the two | Breast cancer stage I–IIIa | NR | primary outcome fatigue measured by the Piper Fatigue scale | 2 years |
Antunes et al. 2023 [9] | Single center Randomized Controlled trial | Portugal | 93 | Combining aerobic and resistance training | 20—24 | 3 | 35—55 | Moderate and vigorous intensity | Usual care | Doxorubicin plus cyclophosphamide +—taxane-based chemotherapy +—plus trastuzumab with or without pertuzumab +—carboplatin and paclitaxel | Breast cancer stage I-III | Mean Adherence 63.2 ± 26.9% | The absolute change in ventricle ejection fraction (LVEF) from baseline to the end of anthracycline cycles | [20–24 weeks intervention] + 3 months follow up |
Chung et al. 2022 [26] | Open-labelled single center Randomized Controlled trial | Taiwan | 32 | Real-time exercise (aerobic exercise, resistance exercise, and flexibility training) | 12 | 2 to 3 | 65 | Moderate-to-high–intensity exercise | Usual care | Chemotherapy every 3 weeks with CEF for 6 cycles (cyclophosphamide 500 mg/m2, epirubicin 75 mg/m2, and 5-FU 500 mg/m2) or doxorubicin plus cyclophosphamide for 4 cycles followed by docetaxel for 4 cycles (doxorubicin 60 mg/m2, cyclophosphamide 600 mg/m2 and docetaxel 60 mg/m2 | Breast cancer stage I–III | 76% | The change in left LVEF | 12 months |
Foulkes et al. 2023 [10](The BREXIT) | Open-labelled single center Randomized Controlled trial | Australia | 104 | Aerobic and resistance Exercise training | 52 | 3 to 4 | 80 -120 | Moderate-to-high–intensity exercise | Usual care | Anthracycline-based chemotherapy +—Taxane +—carboplatin chemotherapy + -Capecitabine chemotherapy | Breast cancer stage I-III | 73% | Functional disability at 12 months, defined as a VO2 peak ≤ 18.0 mL∙kg − 1∙min − 1 | 12 months |
Hojan et al. 2020 [28] (REH-HER) | Open-labelled single center Randomized Controlled trial | Poland | 68 | Regular aerobic/resistance exercise | 9 | 5 | 85—95 | Moderate intensity exercise | General physical activity | Trastuzumab | Breast cancer stage I–IIIa | 98.7% | The differences in cardiac function measured with a capacity test over the nine weeks of the exercise program | 9 weeks |
Hornsby et al. 2014 [29] | RCT | USA | 20 | Aerobic training consisted of one-on-one (nongroup based) supervised cycle ergometry sessions | 12 | 3 | 15–45 | Moderate- to high-intensity exercise | Usual care | Doxorubicin & Cyclophosphamide | Stage IIB–IIIC breast adenocarcinoma | 66% | Safety outcomes included exercise testing as well as treatment- and exercise training-related adverse events (AEs), whereas efficacy outcomes included cardiopulmonary function and patient-reported outcomes (PROs) as measured by a cardiopulmonary exercise test (CPET) and Functional Assessment of Cancer Therapy-Breast (FACT-B) scale | 12 weeks |
Jacquinot et al. 2022 [30] | Multicenter Randomized Controlled trial | France | 89 | Supervised exercise program (aerobic) | 12 | 3 | 55 | Moderate- to high-intensity exercise | Usual care | Trastuzumab | Breast cancer | NR | Test whether trastuzumab induced cardiotoxicity [left ventricular ejection fraction (LVEF) under 50%, or an absolute drop in LVEF of 10%] was reduced after a supervised exercise program of 3 months in patients with HER2-positive breast cancer | 6 months |
Kerrigan et al. 2023 [31] | Multicenter Randomized Controlled trial | USA | 29 | interval training protocol with 4-min high-intensity intervals alternated by 3 min of moderate intensity. (aerobic) | 10 | 2 to 3 | 40—50 | moderate- to high-intensity exercise | Usual care | doxorubicin and/or trastuzumab | breast cancer stages I-IV and leiomyosarcoma | 59% | Our primary aim was to determine whether CR improves exercise capacity in patients who have exhibited subclinical markers of myocardial damage due to doxorubicin or trastuzumab | 10 weeks |
Kirkham et al. 2018 [32] | Randomized Controlled trial | Canada | 27 | Supervised treadmill exercise (aerobic) | 4 Sessions performed, each 24 h prior to each episode of treatment. Up to 2 weeks | NR | 10-min warm-up, 30 min of vigorous and a 5-min cool-down | moderate-to-vigorous physical activity | Abstain from vigorous-intensity exercise from 72 h prior to, and 48 h after the treatment | Doxorubicin | Breast Cancer, stage I–III | 94% adherence to timing, 83% adherence to intensity,98% adherence to duration | To investigate the effect of this intervention on established markers of subclinical cardiotoxicity at the end of treatment | 7–14 days |
Lee et al. 2019 [22] | Randomized pilot clinical trial | USA | 30 | High intensity interval training (aerobic) | 8 | 3 times | 30 | Walking + Moderate + Vigorous | non-exercise | Doxorubicin & cyclophosphamide | Breast Cancer, stage I–III | 82.3% in HIT group | VO2 max change | 9 weeks |
Sturgeon et al. 2022 [23] | Randomized controlled trial | USA | 19 | Tailored home-based remotely delivered (aerobic exercise) | 24 weeks | From week 1–4, 3 sessions/wk with a total of 60min/week at 50% of baseline VO2 max and to 75 + min/wk at 60% of VO2 max at the end of week 4, From week 5–24, 2 sessions/ week at 65–75% of baseline VO2 max | N/R | moderate-to-vigorous | usual level of physical activity | Neoadjuvant with Taxotere, Carboplatin, Herceptin + Perjeta; TCH + P, OR, Adriamycin, cyclophosphamide, Taxol; ACT | Breast Cancer, stage I–III | 87.60% | VO2 max change | 16–24 weeks |
Tsai et al. 2019 [24] | Randomized controlled trial | USA | 22 | Clinic and home-based exercise intervention (aerobic exercise) | 16 weeks | 3 times | 30 min | moderate-to-vigorous | non-exercising | Non-specific | Breast, Sarcoma hip/thigh, Lymphoma, Multiple myeloma, Osteosarcoma, Hodgkin's disease, Leukemia | NR | VO2 max change | 16 weeks |
Courneya et al. 2007 [27] | Multicenter prospective, three-armed, randomized controlled trial | Canada | 242 | Aerobic exercise training (AET) and resistance exercise training (RET) | Median 17 weeks, 95% CI (9 to 24 weeks) | 3 times | 15 min for weeks 1 to 3, increased by 5 min every 3weeks till 45 min at week 18 | Vigorous | Usual care | Nontaxane and Taxane both | Breast cancer stage, I–IIIA | 70.2% | Cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy–Anemia scale | (9–24 chemotherapy treatment) + 3 to 4 weeks after chemotherapy |