The role of physical activity in modulating immune biomarkers and oxidative stress among cancer patients: a systematic review

Introduction: physical activity (PA) is recognized as a safe and beneficial intervention for individuals diagnosed with cancer. It is recommended that all cancer patients engage in regular physical activity as an integral component of a comprehensive treatment plan. Objective: to critically evaluate the role of physical activity in modulating immune and oxidative stress biomarkers in cancer patients. Methodology: A comprehensive search across several prominent academic databases—including ScienceDirect, PubMed, Springer, Scopus, Taylor & Francis, Sage, Google Scholar, and Wiley—resulted in the identification of 1,447 relevant articles. A total of eleven studies that satisfied the inclusion criteria were incorporated into the narrative review, followed by an assessment of the risk of bias for each study using the RoB 2.0 tool. Results: of the eleven studies analyzed, 36.4% had low bias risk, 18.2% had potential bias concerns, and 45.5% had high bias risk. Discussion: PA has been repeatedly demonstrated to influence the regulation of immune responses and oxidative stress indicators in individuals with cancer. It aids in boosting the function of immune cells, including CD8⁺ T lymphocytes and NK cells, and promotes the activation of antioxidant enzymes such as SOD, CAT, and GPX. Additionally, it reduces pro-inflammatory markers and supports gene and cytokine expression related to immune regulation, making it a promising adjuvant to improve cancer therapy outcomes. Conclusions: PA has been demonstrated to enhance immune system performance and mitigate oxidative stress among cancer patients, concurrently augmenting the cytotoxic capabilities of NK cells and CD8⁺ T lymphocytes in targeting and destroying malignant cells.