Association of physical activity with survival and severe immune-related adverse events in patients undergoing immune checkpoint inhibition.

Abstract

For patients diagnosed with advanced-stage cancer, immunotherapies, known as immune checkpoint inhibitors (ICIs), have improved outcomes for many patients. These new treatments target the immune system to maximise its function and attack cancer cells. However, there is a major downside to these drugs: they can cause severe adverse events due to the heightened immune response and are known as immune-related adverse events (irAEs). The novelty of these drugs highlights that further research is needed to find specific characteristics and lifestyle behaviours of patients that could affect overall survival (OS) and the occurrence of immune-related adverse events. Given the well-established connection between exercise and improved immune-system function, it is hypothesized that physical activity (PA) could enhance the effectiveness of immunotherapy. In this study, we investigated the association between PA and OS and the development of irAEs of patients undergoing ICI therapy. To conduct this research, participants reported their average weekly PA levels through a questionnaire, at the onset of treatment, and relevant clinical data was collected. The main research questions were studied using various statistical analyses including survival analysis and logistic regression, for OS and correlations with irAEs, respectively. Our results show that patients who report higher levels of PA have improved OS, and lower occurrence of irAEs, however future research is needed to investigate whether sedentary patients could benefit from increased PA after diagnosis.