Association Of High-intensity Exercise With Inflammatory Markers In Breast Cancer Survivors - Data From The Optitrain Rct

Breast cancer and corresponding treatment strategies are associated with increased systemic inflammation. Exercise has been shown to reduce inflammation and is also associated with a long-term favorable prognosis in breast cancer survivors. The Optitrain randomized controlled trial (RCT) was designed to test the effect of high-intensity training (HIIT) in female breast cancer patients. In previous reports, we showed an acute increase in pro-inflammatory markers after chemotherapy in all groups, partly mitigated by training. PURPOSE: To investigate the effects of a high intensity exercise intervention during chemotherapy on inflammatory markers one year after diagnosis. METHODS: Overall, 240 female breast cancer patients were randomised into three groups: [1] aerobic HIIT (AT-HIIT) exercise, [2] resistance HIIT (RT-HIIT) exercise, and [3] usual care (UC). All participants in the intervention group that had attended >60% of the exercise sessions were included in this per-protocol analysis, and a matched UC sample was randomly selected. At baseline, post-intervention, and the one-year follow-up, 96 inflammatory protein biomarkers were assessed using the Olink® Target 96 Oncology Panel. Between-group differences at the one-year follow-up were assessed using an analysis of covariance adjusted for baseline levels of inflammation. RESULTS: At the one-year follow-up, chemotherapy-associated increases in inflammation were mostly resolved. There were some differences in inflammatory markers in the intervention groups compared to UC. Most differences were seen in the RT-HIIT group. Briefly, several chemokine ligands were lower in the RT-HIIT intervention group compared to the control using an exploratory (p<0.2) approach (e.g., CCL13, CCL2, CCL20, CCL23, CCL3, CCL4, CX3SL1, CXCL10). Differences in decorin and ICOSLG reached statistical significance (p<0.05).. In contrast, fewer exploratory differences were found (CSF-1, decorin, NCR1) in the AT-HIIT group, and none of the differences in this group reached statistical significance CONCLUSION: At the one-year follow-up of the Optitrain trial, inflammatory markers have fallen to near-baseline levels. However, some group differences in inflammation were found between the exercise groups and the control after a HIIT exercise intervention. Research grants obtained for this analysis include (1) Swedish Cancer Society (130452 to Wengström), (2) Swedish Society for Medical Research (SLS 50514 to Rundqvist), (3) Cancer Society of Stockholm (131242 to Wengström).