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@ARTICLE{Zimmer:293958,
      author       = {P. Zimmer and T. Esser and D. Lueftner and F. Schuetz and
                      F. T. Baumann and A. Rody and A. Schneeweiss and A. D.
                      Hartkopf and T. Decker and C. Uleer and O. J. Stoetzer and
                      F. Foerster and M. Schmidt and C. Mundhenke and K.
                      Steindorf$^*$ and H. Tesch and C. Jackisch and T. Fischer
                      and S. Hanson and J. Kreuzeder and G. Guderian and P. A.
                      Fasching and W. Bloch},
      title        = {{P}hysical activity levels are positively related to
                      progression-free survival and reduced adverse events in
                      advanced {ER}+ breast cancer.},
      journal      = {BMC medicine},
      volume       = {22},
      number       = {1},
      issn         = {1741-7015},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer},
      reportid     = {DKFZ-2024-02023},
      pages        = {442},
      year         = {2024},
      abstract     = {Increased levels of physical activity are associated with a
                      reduction of breast cancer mortality, especially in
                      postmenopausal women with positive hormone receptor status.
                      So far, previous observational case-control and cohort
                      studies have focused on associations between overall leisure
                      time physical activity and survival of women with breast
                      cancer in general.In this multicenter prospective cohort
                      study, conducted in Germany between 30th August 2012 to 29th
                      December 2017, we investigated general physical activity in
                      a homogenous sample of n = 1440 postmenopausal women with
                      advanced (inoperable locally advanced or metastatic),
                      hormone receptor-positive breast cancer receiving the same
                      therapy (everolimus and exemestane). Self-reported physical
                      activity was assessed using the Godin Leisure Time Exercise
                      Questionnaire (GLTEQ) before and every 3 months during
                      treatment. Participants were then classified into 'active'
                      and 'insufficiently active' to screen their activity
                      behavior the week prior to medical treatment. In addition,
                      changes in physical activity patterns were assessed.
                      Adjusted Cox regression analyses were performed for the
                      activity categories to determine hazard ratios (HR). Besides
                      progression-free survival (PFS), adverse events (AEs), QoL,
                      and fatigue were assessed every 3 months until study
                      termination.Compared to 'insufficiently active' patients,
                      'active' individuals indicated a significantly longer PFS
                      (HR: 0.84 [0.74; 0.984], p = .0295). No significant
                      differences were observed for changes of physical activity
                      behavior. Patients who reported to be 'active' at baseline
                      revealed significantly fewer AEs compared to
                      'insufficiently' active patients. In detail, both severe and
                      non-severe AEs occurred less frequently in the 'active'
                      patients group. In line with that, QoL and fatigue were
                      better in physical 'active' patients compared to their
                      insufficient active counterparts at the last post-baseline
                      assessment. Participants who remained or become active
                      indicated less AEs, a higher QoL, and reduced fatigue
                      levels.Physical activity behavior prior to medical treatment
                      might have prognostic value in patients with advanced breast
                      cancer in terms of extending the PFS. Moreover, physical
                      activity before and during treatment may reduce
                      treatment-related side effects and improve patients' QoL and
                      fatigue.EUPAS9462. Registered 30th October 2012
                      'retrospectively registered.'},
      keywords     = {Adverse events (Other) / Breast cancer (Other) / Exercise
                      (Other) / Fatigue (Other) / Physical activity (Other) /
                      Quality of life (Other) / Survival (Other)},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39379960},
      doi          = {10.1186/s12916-024-03671-x},
      url          = {https://inrepo02.dkfz.de/record/293958},
}