Reducing the Rate of Treatment Disruptions Through a Digital Structured Exercise and Mind–Body Program During Systemic Cancer Therapy: A Secondary Analysis of a Randomized Clinical Trial

TL;DR

A digital exercise and mind-body program may help reduce treatment interruptions during cancer therapy, though more research is needed.

Contribution

This study is among the first to explore digital mind-body and exercise programs' impact on treatment disruptions during cancer therapy.

Findings

IM@Home participants had fewer repeated treatment interruptions compared to usual care.

The program did not significantly reduce the chance of stopping treatment altogether.

Digital programs may help patients manage symptoms and stay on track with treatment.

Abstract

Cancer treatments can be delayed, reduced, or stopped due to side effects like fatigue, which can affect a patient’s treatment outcomes. This study explored whether a digital exercise and mind–body program, Integrative Medicine at Home (IM@Home), could help reduce treatment discontinuations and treatment disruptions. A total of 127 patients with cancer reporting moderate to severe fatigue were randomly assigned to either a 12-week IM@Home program or enhanced usual care (EUC) group. We examined whether participation in IM@Home affected treatment discontinuation and other treatment disruptions, including dose delays and reductions. Our findings suggest that patients who participated in IM@Home had fewer repeated treatment interruptions during the study period. Although the program did not clearly reduce the chance of stopping treatment altogether, it appeared to help reduce ongoing disruptions once challenges occurred. These early findings suggest that supportive digital programs may help patients better manage symptoms and stay on track with treatment. More research is needed to confirm these results.

Background/Objectives: Treatment disruptions and discontinuations during systemic cancer therapy are common and can compromise treatment delivery and outcomes. Structured exercise and mind–body interventions improve cancer-related symptoms, but their impact on treatment disruptions and discontinuations remains unclear. This secondary analysis of the IMPROVE trial evaluated whether participation in Integrative Medicine at Home (IM@Home), a digital multimodal mind–body and structured exercise program, was associated with differences in treatment discontinuation and related treatment disruption outcomes among patients undergoing systemic therapy. Methods: A total of 127 adults with solid tumors were randomized to IM@Home (n = 64) or enhanced usual care (EUC; n = 63) for 12 weeks. Treatment discontinuation, dose delays, dose reductions, and overall treatment disruptions were compared between arms using chi-square tests and regression models adjusted for cancer type and disease stage. Results: In unadjusted analyses, treatment discontinuation occurred less frequently in the IM@Home group compared with EUC (9.4% vs. 22.6%; p = 0.043), but this association was attenuated after adjustment for cancer type and disease stage (aOR 0.41, 95% CI 0.13–1.17; p = 0.105). The proportion of patients experiencing any treatment disruption, as well as rates of dose delays and dose reductions, did not differ significantly between groups (p = 0.16, p = 0.18, and p = 0.85, respectively). In contrast, IM@Home participants experienced fewer treatment disruption events per patient (adjusted RR 0.58, 95% CI 0.35–0.96; p = 0.036). Conclusions: These exploratory findings suggest that digital structured exercise and mind–body programs may help mitigate treatment interruptions during systemic cancer therapy and should be explored further in an adequately powered prospective trial to confirm these promising findings.

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