Supervised exercise training in patients with cancer during anthracycline-based chemotherapy to mitigate cardiotoxicity - a randomized controlled trial.
Bibliographic record
Abstract
Background Exercise training (ET) has been shown to mitigate cardiotoxicity of anthracycline-based chemotherapies (AC) in animal models. Data from randomized controlled trials in patients with cancer are sparse. Methods Patients with breast cancer or lymphoma receiving AC were recruited from four cancer centres and randomly assigned to three months supervised ET during (EXduringAC) or after (EXpostAC) AC. All patients were counselled on physical activity (PA) and PA was objectively measured with an activity tracker with PA feedback option. Primary endpoint was change in left ventricular global longitudinal strain (GLS) between baseline and AC completion (AC-end) assessed by transthoracic 2D echocardiography. Secondary endpoints were change in high sensitivity Troponin T (hsTnT) and NT-pro-brain natriuretic peptide (NT-proBNP) between baseline and AC-end. Exploratory analyses were performed at 6 months (follow-up). Primary and exploratory analysis were performed by linear mixed models and robust linear models, respectively. Results One-hundred-and-forty-three patients were eligible for the study. Fifty-seven patients (median age 47 [1st and 3rd quartiles 38, 57] years; 95% women) consented to participate, of whom 28 and 29 patients were randomized to the EXduringAC and EXpostAC group, respectively. GLS deteriorated in both study groups from baseline to AC-end with 7.4% and 6.2% relative increase in EXduringAC and EXpostAC, respectively, and hsTnT and NT-proBNP significantly increased in both groups, without difference between groups for any parameter. Duration of moderate-to-vigorous PA (MVPA) was also similar between groups with a median of 33 [26, 47] min/day and 32 [21, 59] min/day in the EXduringAC and EXpostAC group, respectively. In the robust linear model including the pooled patient population, MVPA was significantly associated with a more negative GLS and lesser increase in hsTnT. Conclusion In physically active patients with cancer receiving AC, supervised ET during chemotherapy was not superior to PA advice and tracker monitoring only to mitigate cardiotoxicity. Objectively measured PA was inversely related to markers of LV function and myocardial injury.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".