OS07.7.A FEASIBILITY, SAFETY, AND EFFECTS OF A HIGH-INTENSITY EXERCISE PROGRAM (ACTINO) IN PATIENTS WITH HIGH-GRADE GLIOMA

Abstract BACKGROUND Patients with high-grade gliomas (HGG) are heavily impacted by both disease and treatment-associated symptoms. Although exercise interventions have been shown to enhance physical fitness and quality of life (QoL) in oncology, high-intensity training programs are rarely applied in neuro-oncological settings. This study aimed to assess the feasibility, safety, and effectiveness of “Active in Neuro-Oncology” (ActiNO), a structured, intensive 16-week strength and endurance exercise program designed for HGG patients undergoing adjuvant chemotherapy. MATERIAL AND METHODS This prospective, oligocentric, single-arm proof-of-concept trial enrolled 54 patients with HGG, who participated in biweekly supervised exercise sessions. Cardiorespiratory fitness, the primary endpoint, was assessed by physical working capacity (PWC) at 75% of the age-predicted maximum heart rate during a maximal cardiopulmonary exercise test. Secondary outcomes comprised peak oxygen uptake (VO₂peak), peak power output (Ppeak), physical functioning, and global health (assessed by EORTC-QLQ-C30). Changes from baseline to post-intervention were analyzed within subjects, and all outcomes were additionally compared against established normative data. Feasibility was evaluated based on recruitment rates, adherence, and drop-out, while safety was monitored via systematic adverse event (AE) reporting. RESULTS Program tolerance was high, with few minor exercise-related adverse events. Over the 16 weeks, improvements were observed across all key fitness outcomes: PWC improved by 23% (from 1.023 to 1.256 W/kg), VO₂peak by 13% (from 23.04 to 26.09 ml/min/kg), and Ppeak by 19% (from 1.771 to 2.104 W/kg) (p<0.05, all comparisons). In addition, global health status and physical functioning improved, reaching normative levels by the end of the intervention. Program adherence was 85%; however, the drop-out rate was high (48%), primarily due to disease progression. CONCLUSION Supervised high-intensity exercise is feasible and safe for selected HGG patients during adjuvant chemotherapy. The demonstrated improvements of physical fitness and QoL underline the importance of incorporating structured exercise into neuro-oncological care pathways, while future programs should consider more adaptive or individualized designs to address the challenges of high drop-out rates in this vulnerable patient group.