BReast Cancer Randomized EXercise InTervention - BREXIT
Contribution To Literature:
The BREXIT trial failed to show that exercise training prevented functional disability.
The goal of the trial was to evaluate exercise training compared with usual care among women with breast cancer undergoing anthracycline-based chemotherapy.
Women with breast cancer undergoing anthracycline-based chemotherapy were randomized to exercise training (n = 52) vs. control (n = 52) for 12 months. Exercise training consisted of 3–4 days per week of aerobic and anaerobic exercise.
- Total number of enrollees: 104
- Duration of follow-up: 12 months
- Mean patient age: 50 years
- Percentage female: 100%
- Percentage with diabetes: 2%
- Women 40–75 years of age
- Stage 1–3 breast cancer
- Structural heart disease
- Contraindication to cardiac magnetic resonance imaging
- Contraindication to exercise
- Non-English speaking
- Significant cognitive impairment
The primary outcome, functional disability at 12 months, defined as peak volume of oxygen uptake (VO2peak) ≤18.0 mL/kg/min, was similar for exercise vs. control (odds ratio 0.27, 95% confidence interval 0.06-1.12, p = 0.07).
- Change in VO2peak from baseline to 12 months: +2.0 mL/kg/min in the exercise group vs. -1.5 mL/kg/min in the control group (p < 0.001)
- Change in left ventricular ejection fraction (LVEF) from baseline to 12 months: -2.2% in the exercise group vs. -1.2% in the control group (p = 0.42)
- Change in B-type natriuretic peptide (BNP) from baseline to 12 months: 9.4 ng/L in the exercise group vs. 6.5 ng/L in the control group (p = 0.30)
Among women with breast cancer undergoing anthracycline-based chemotherapy, exercise training failed to prevent functional disability. Exercise training produced a mixed picture with modest improvement in VO2peak but no improvement in LVEF or BNP.
Foulkes SJ, Howden EJ, Haykowsky MJ, et al. Exercise for the Prevention of Anthracycline-Induced Functional Disability and Cardiac Dysfunction: The BReast Cancer Randomized EXercise InTervention (BREXIT) Study. Circulation 2022;Nov 7:[Epub ahead of print].
Clinical Topics: Cardio-Oncology, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Exercise
Keywords: Anaerobiosis, Anthracyclines, Breast Neoplasms, Cardiotoxicity, Exercise, Exercise Therapy, Heart Failure, Natriuretic Peptide, Brain, Oxygen Consumption, Primary Prevention, Stroke Volume, Ventricular Function, Left
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