Effects of combined physical training in women with Breast Cancer submitted to chemotherapy

• Grant number: 21/01424-5
• Support Opportunities: Research Grants - Young Investigators Grants
• Start date: December 01, 2022
• End date: November 30, 2027
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: Miguel Soares Conceição
• Grantee: Miguel Soares Conceição
• Host Institution: Universidade São Francisco (USF). Campus Bragança Paulista. Bragança Paulista , SP, Brazil
• Associated researchers: Andréia de Melo Porcari ; Carlos Ugrinowitsch ; Eva Maria Zopf ; Felipe Cassaro Vechin ; Luís Otávio Zanatta Sarian ; Marcelo Alves da Silva Mori ; Pedro Manoel Mendes de Moraes Vieira ; Sophie Françoise Mauricette Derchain
• Associated research grant(s): 23/01556-4 - Effects of combined physical training on cardiac autonomic modulation in women with Breast Cancer undergoing chemotherapy, AP.R
• Associated scholarship(s): 24/22777-1 - Chronic systemic response of inflammatory chemokines, muscle mass, and body fat percentage after combined training performed before treatment in women with breast cancer, BP.MS; 24/21103-7 - Targeted Investigation of Tricarboxylic Acid (TCA) Cycle Metabolites in Women with Breast Cancer Undergoing Combined Training, BP.MS; 23/14615-9 - EFFECTS OF COMBINED TRAINING ON TUMOR BLOOD FLOW IN BREAST CANCER PATIENTS, BP.PD; + associated scholarships 23/02510-8 - Effect of combined training, performed before treatment, on the transcriptomic and metabolomic profile of the tumor of women with Breast Cancer, BP.DD; 23/02398-3 - Effect of combined training performed before treatment on cell proliferation and tumor c-miRNA expression in women with breast cancer, BP.MS; 23/02500-2 - Effects of combined training performed before treatment on strength, muscle mass and aerobic fitness on systemic inflammatory cytokines in women with breast cancer, BP.MS - associated scholarships

Abstract

Tumor growth and neoadjuvant treatment induce degradation of muscle mass and cardiorespiratory fitness in women with Breast Cancer. This damage to muscle mass and cardiorespiratory fitness can increase toxicity and decrease the effectiveness of chemotherapy. Since the performance of strength training and aerobic training, called Combined Training (CT), is an efficient strategy to increase muscle mass and cardiorespiratory fitness, CT should be performed before chemotherapy to reduce its adverse effects. In addition, it is known that the tumor consumes large amounts of glucose, due to its glycolytic metabolism. Due to this metabolism, the tumor can cause insulin resistance, in order to direct a greater amount of glucose to its consumption and increase proliferation. Since CT can decrease the amount of circulating glucose, it is possible to suggest that the decrease in circulating glucose will alter the tumor's metabolism, making it less able to consume glucose and then decrease its proliferation. Other mechanisms, such as the expression of c-miRNAs after physical training, may contribute to decreasing the aggressiveness of the tumor. Objectives: To determine the effect of the CT performed between the diagnosis of Breast Cancer and before the beginning of treatment on the following variables: a) muscle mass, b) muscle strength, c) aerobic fitness, d) physical functionality, e) quality of life, f) Ki67 levels in the tumor, g) systemic inflammatory profile, h) transcriptomic profile of the tumor, i) profile Tumor metabolomics, j) profile basal levels and the acute response to exercise of c-miRNAs expression. In addition, determining the remaining effect (after the end of treatment) of the CT on the variables: a) muscle mass, b) muscle strength, c) aerobic power, d) physical functionality, e) quality of life, f) baseline levels of expression of c-miRNAs, g) systemic inflammatory profile and h) treatment toxicity and i) cancer-related fatigue. Methods: Assuming a sampling error of a maximum of 10%, with a confidence interval of 95%, a minimum sample of 100 cases will be required. Thus, 100 women with Breast Cancer with an indication for neoadjuvant chemotherapy will be allocated to one of the following groups: CT before chemotherapy (CT, n = 50), or control group (CG, n = 50). Then, these women will perform, both before the CT period and after, the following assessments: 1) body composition by dual-energy X-ray absorptiometry (DXA); 2) muscle strength through the test of a maximum repetition (1-RM); 3) cardiorespiratory fitness through the direct test of maximum oxygen consumption (VO2max); 4) functionality through the sit and stand and Timed Up and Go tests; 05) quality of life through the FACT-B questionnaire; 6) nutritional intake through food records; 7) blood and tumor collections for molecular analysis. The same assessments of muscle mass, muscle strength, aerobic power, physical functionality, and quality of life, as well as blood collections, will be performed again at the end of cancer treatment. At that time, cancer-related toxicity and fatigue analysis will also be performed. Blood samples for molecular analysis will be collected in 6 moments: 1st) before the first CT session; 2nd) immediately after the first CT session; 3rd) before the last TC session; 4th) immediately after the last CT session; 5th) 3 days after 8 weeks of CT; 6th) After the cancer treatment period. The CT will be performed 3 times a week. The CT protocol will consist of strength training (TF: 8 exercises, 1-3 sets of 8-12 RM at 80-90% of 1-RM and 2 min between sets) followed by aerobic training (3-4 sets from 3 min to 90% of VO2max for 3 min of active recovery (30% of VO2max) on the cycle ergometer. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

BUZAGLO, GLENDA B. B.; TELLES, GUILHERME D.; ARAUJO, RAFAELA B.; JUNIOR, GILMAR D. S.; RUBERTI, OLIVIA M.; FERREIRA, MARINA L. V.; DERCHAIN, SOPHIE F. M.; VECHIN, FELIPE C.; CONCEICAO, MIGUEL S.. The Therapeutic Potential of Physical Exercise in Cancer: The Role of Chemokines. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, v. 25, n. 24, p. 18-pg., 2024-12-01. (21/01424-5, 23/02500-2)