# Structured Exercise During Chemotherapy for Locally Advanced or Metastatic Pancreatic Cancer: A Single‐Arm, Feasibility Trial

## TL;DR

A 12-week exercise program during chemotherapy for advanced pancreatic cancer was found to be feasible and safe, with benefits to physical fitness and emotional well-being.

## Contribution

This study provides real-world feasibility data on structured exercise during chemotherapy for advanced/metastatic pancreatic cancer patients.

## Key findings

- Exercise adherence and attendance rates were high, with minimal adverse events.
- Significant improvements in physical activity, grip strength, and emotional/social functioning were observed.
- Patients with stage IV disease and home-based participants showed greater benefits.

## Abstract

Evidence on structured exercise during systemic treatment for patients with locally advanced or metastatic pancreatic cancer is still limited, and detailed feasibility data in real‐world clinical settings remain scarce. This study aimed to assess the feasibility, safety, and preliminary efficacy of a 12‐week exercise intervention in this population.

In this prospective single‐arm trial, 20 patients undergoing chemotherapy participated in a supervised exercise program comprising aerobic and resistance training, delivered twice weekly for 12 weeks. Participants could choose between supervised gym‐based or home‐based sessions. Primary outcomes included recruitment, retention, attendance, adherence, tolerance, and safety. Secondary outcomes were changes in physical fitness and patient‐reported outcomes. Descriptive statistics and paired t‐tests or Wilcoxon signed‐rank tests were used for analyses. Exploratory subgroup analyses were conducted by tumor stage and exercise delivery mode.

The recruitment rate was 80%, with a 43% dropout rate primarily due to disease progression or treatment‐related toxicities. Median session attendance was 79%, and adherence to prescribed exercise volume reached 77%. Only three non‐serious adverse events were reported. Significant improvements were observed in grip strength (p = 0.049), total weekly physical activity (p = 0.024), and time spent in moderate‐intensity activity (p < 0.001). Emotional (p = 0.022) and social functioning (p = 0.048) significantly improved, while appetite loss decreased (p = 0.010). Subgroup analyses suggested greater benefits in patients with stage IV disease and those in the home‐based group.

Exercise during chemotherapy appears feasible and safe for patients with advanced/metastatic pancreatic cancer, and it may help maintain physical fitness, enhance emotional and social well‐being, and alleviate appetite loss. However, different strategies are required to reduce the dropout rate.