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@ARTICLE{Schmidt:301741,
      author       = {M. Schmidt$^*$ and S. Goldschmidt$^*$ and C. Kreutz$^*$ and
                      J. Müller and A. Schneeweiss and A. M. May and F.
                      Rosenberger and J. Wiskemann and K. Steindorf$^*$},
      title        = {{E}ffects of aerobic or resistance exercise during
                      neoadjuvant chemotherapy on tumor response and therapy
                      completion in women with breast cancer: {T}he randomized
                      controlled {BENEFIT} trial.},
      journal      = {Journal of sport and health science},
      volume       = {14},
      issn         = {2095-2546},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-01125},
      pages        = {101064},
      year         = {2025},
      note         = {#EA:C110#LA:C110# / Volume 14, December 2025, 101064},
      abstract     = {The potential of exercise as a concurrent therapy for
                      actively treated primary tumors has been suggested by
                      emerging preclinical and observational studies. However,
                      clinical trials regarding this question are scarce.
                      Therefore, we conducted a randomized controlled trial
                      investigating the effects of aerobic or resistance exercise
                      concomitant to neoadjuvant chemotherapy (NACT) on tumor
                      size.IN THE BENEFIT STUDY (GERMAN TITLE: BEwegung bei
                      NEoadjuvanter Chemotherapie zur Verbesserung der FITness),
                      patients with breast cancer scheduled for NACT were randomly
                      assigned to supervised resistance training (RT, n = 60) or
                      aerobic training (AT, n = 60) twice weekly during NACT or to
                      a waitlist control group (WCG, n = 60). The primary outcome,
                      'change in tumor size', as well as the secondary clinical
                      outcomes pathologic complete response (pCR), type of surgery
                      (breast conserving/mastectomy), axillary lymph node
                      dissection (ALND, yes/no), premature discontinuation of
                      chemotherapy (yes/no), and relative dose intensity (RDI)
                      were derived from clinical records. Due to the highly skewed
                      distribution, the primary outcome was categorized. Multiple
                      (ordinal) logistic regression analyses were
                      performed.Overall, there was no significant difference in
                      post-intervention tumor size between RT or AT and WCG.
                      However, there was a significant effect modification by
                      hormone receptor (HR) status (pinteraction = 0.030). Among
                      patients with HR+ tumors, results suggest a beneficial
                      effect of AT on tumor shrinkage (odds ratio (OR) = 2.37,
                      $95\%CI:$ 0.97‒5.78), on pCR (OR = 3.21, $95\%CI:$
                      0.97‒10.61); and on ALND (OR = 3.76, $95\%CI:$
                      0.78‒18.06) compared to WCG. The effects of RT were
                      slightly less pronounced. For HR- subtypes, beneficial
                      effects on RDI were found for AT (OR = 3.71, $95\%CI:$
                      1.20‒11.50) and similarly for RT (OR = 2.58, $95\%CI:$
                      0.88‒7.59). Both AT and RT had favorable effects on
                      premature discontinuation of chemotherapy (OR (no vs. yes) =
                      2.34, $95\%CI:$ 1.10‒5.06), irrespective of tumor receptor
                      status.While there was no significant effect on the primary
                      outcome in the overall group, aerobic and resistance
                      exercise concomitant to NACT seem to beneficially affect
                      tumor shrinkage and pCR, reduce the need for ALND among
                      patients with HR+ breast cancers, and prevent low RDI among
                      patients with HR- breast cancers. These results warrant
                      confirmation in further trials.},
      keywords     = {Clinical cancer outcomes (Other) / Neoadjuvant chemotherapy
                      (Other) / Pathologic complete response (Other) / Supervised
                      exercise (Other) / Tumor response (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:40447136},
      doi          = {10.1016/j.jshs.2025.101064},
      url          = {https://inrepo02.dkfz.de/record/301741},
}