Resistance training in cachectic pancreatic and lung cancer patients: randomised controlled trial

OBJECTIVES: Pancreatic and lung cancer are associated with cancer cachexia (CC), which negatively impacts patients' quality of life, treatment outcomes and prognosis. This study aimed to evaluate the feasibility and effectiveness of a 24-week eccentrically overloaded resistance training (ERT) in patients with CC. METHODS: 22 patients with pancreatic or lung cancer and CC were randomised (2:1) to either supervised ERT (n=14) and usual care (UC, n=8). ERT was performed twice weekly for 24 weeks. Feasibility was assessed through recruitment rate, dropouts, adverse events (AEs) and exercise adherence. Secondary outcomes included body composition, physical performance and patient-reported outcomes (PROs) in quality of life, fatigue, anxiety and depression, anorexia-cachexia symptoms and physical activity levels. Assessments were conducted at baseline, 12 weeks (ITT1) and after 24 weeks (ITT2). RESULTS: The recruitment rate was 21.8%. 10 dropouts (45.5%) were recorded (ERT: n=7, UC n=3). Clinical AEs were comparable between the groups. Two AEs occurred during or after an exercise session, but resolved completely. The exercise adherence was 63.7%. After 12 weeks, the ERT group improved significantly in aerobic capacity, functional strength and several PROs, while the UC group improved in PROs depression and physical activity levels. After 24 weeks, body composition worsened in the UC group compared with the ERT group (p=0.026). Intragroup analysis showed improvements in PRO domains in the ERT group and decreases of the phase angle in the UC group. CONCLUSIONS: Supervised ERT seems feasible in cachectic cancer patients and may preserve or enhance physical performance, constitution and PROs.