Gonzalo-Encabo Paola, Wilson Rebekah L, Kang Dong-Woo, Norris Mary K, Uno Hajime, Christopher Cami N, Chow Christina, Sami Nathalie, Fox Frank S, Ligibel Jennifer A, Dieli-Conwright Christina M
Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.
Department of Medicine, Harvard Medical School, Boston, MA, United States.
Front Oncol. 2022 May 10;12:864844. doi: 10.3389/fonc.2022.864844. eCollection 2022.
Latina and Hispanic breast cancer survivors (LHBCS) are at increased risk for long-term complications and poorer metabolic health, including metabolic dysregulation (MetD) before and following breast cancer diagnosis. MetD can increase risk of cancer recurrence, death, and comorbid conditions by increasing inflammation and cancer cell proliferation. While exercise improves physical fitness and metabolic outcomes in breast cancer survivors, there is a lack of studies including underrepresented and disadvantaged minority groups such as LHBCS.
Our 12-month randomized (exercise or attention control) controlled trial (the ROSA trial) aims to utilize a progressive combined aerobic and resistance exercise program to improve MetD, insulin resistance, and visceral adiposity among obese LHBCS. We aim to recruit 160 women with Stage I-III breast cancer who are sedentary, centrally obese, and have completed treatment (e.g., surgery, radiation, chemotherapy) prior to enrollment. Participants randomized to the exercise group receive 16-weeks of virtually supervised aerobic and resistance training, followed by 16-weeks of unsupervised home-based aerobic and resistance exercise, and 16-weeks of follow-up. The attention control group receive a 12-month home-based stretching program. Primary and secondary outcomes are measured every 4-weeks during study visits.
The ROSA trial is the first exercise oncology trial targeting high-risk sedentary, obese LHBCS to improve MetD-related outcomes. Results of this trial will help illuminate how exercise impacts health-related outcomes, survivorship, and recurrence, and inform future exercise oncology guidelines to reduce health disparities among minority cancer survivors.
拉丁裔和西班牙裔乳腺癌幸存者（LHBCS）面临长期并发症和代谢健康状况较差的风险增加，包括在乳腺癌诊断之前和之后的代谢失调（MetD）。MetD可通过增加炎症和癌细胞增殖来增加癌症复发、死亡和合并症的风险。虽然运动可改善乳腺癌幸存者的身体素质和代谢结果，但缺乏包括LHBCS等代表性不足和处境不利的少数群体的研究。
我们为期12个月的随机（运动或注意力控制）对照试验（ROSA试验）旨在利用渐进式有氧和抗阻运动相结合的计划来改善肥胖LHBCS的MetD、胰岛素抵抗和内脏脂肪。我们的目标是招募160名患有I-III期乳腺癌的女性，她们久坐不动、中心性肥胖，且在入组前已完成治疗（如手术、放疗、化疗）。随机分配到运动组的参与者接受16周的虚拟监督有氧和抗阻训练，随后是16周的无监督家庭有氧和抗阻运动，以及16周的随访。注意力控制组接受为期12个月的家庭伸展计划。在研究访视期间每4周测量一次主要和次要结果。
ROSA试验是第一项针对高危久坐、肥胖LHBCS以改善与MetD相关结果的运动肿瘤学试验。该试验的结果将有助于阐明运动如何影响与健康相关的结果、生存率和复发情况，并为未来的运动肿瘤学指南提供信息，以减少少数族裔癌症幸存者之间的健康差距。
