Precision Oncology Framework for Investigation of Exercise as Treatment for Cancer

open access

Introduction

In recent years, a new line of investigation has emerged that addresses the novel question of whether exercise has an impact on cancer outcomes. Advances in genomic profiling have increased our understanding of the molecular and genetic complexity of human cancer and, although many challenges remain,^1,2 several scenarios suggest that successfully matching a genomic alteration with drug therapies that target the alteration can result in striking durable responses.^2,3 Critical prerequisites underlying these successes include having an adequate understanding of the biologic mechanisms of the drug's action, identifying the biologically effective dose, and determining the predictors of response to guide patient selection. Arguably, elucidation of these prerequisites is required to optimize the efficacy of any therapeutic strategy,⁴ including exercise treatment.

Almost a decade ago, the National Cancer Institute published a framework outlining a sequence of steps to facilitate the advancement of candidate lifestyle interventions, including exercise, from early discovery to definitive phase III trials in cancer control.⁵ Unfortunately, research in exercise-oncology, in general, has not adhered to the National Cancer Institute's recommendations nor has it taken advantage of the recent developments in genomic medicine.....