Effect of the Rehabilitation Program, ReStOre, on Serum Biomarkers in a Randomized Control Trial of Esophagogastric Cancer Survivors

Abstract

BackgroundThe Rehabilitation Strategies Following Esophagogastric cancer (ReStOre) randomized control trial demonstrated a significant improvement in cardiorespiratory fitness of esophagogastric cancer survivors. This follow-up, exploratory study analyzed the biological effect of exercise intervention on levels of 55 serum proteins, encompassing mediators of angiogenesis, inflammation, and vascular injury, from participants on the ReStOre trial.MethodsPatients >6 months disease free from esophagogastric cancer were randomized to usual care or the 12-week ReStOre program (exercise training, dietary counselling, and multidisciplinary education). Serum was collected at baseline (T0), post-intervention (T1), and at 3-month follow up (T2). Serum biomarkers were quantified by enzyme-linked immunosorbent assay (ELISA).ResultsThirty-seven patients participated in this study; 17 in the control arm and 20 in the intervention arm. Exercise intervention resulted in significant alterations in the level of expression of serum IP-10 (mean difference (MD): 38.02 (95% CI: 0.69 to 75.35)), IL-27 (MD: 249.48 (95% CI: 22.43 to 476.53)), and the vascular injury biomarkers, ICAM-1 (MD: 1.05 (95% CI: 1.07 to 1.66)), and VCAM-1 (MD: 1.51 (95% CI: 1.04 to 2.14)) at T1. A significant increase in eotaxin-3 (MD: 2.59 (95% CI: 0.23 to 4.96)), IL-15 (MD: 0.27 (95% CI: 0 to 0.54)) and decrease in bFGF (MD: 1.62 (95% CI: -2.99 to 0.26)) expression was observed between control and intervention cohorts at T2 (p<0.05).ConclusionsExercise intervention significantly altered the expression of a number of serum biomarkers in disease-free patients who had prior treatment for esophagogastric cancer.ImpactExercise rehabilitation causes a significant biological effect on serum biomarkers in esophagogastric cancer survivors.Clinical Trial RegistrationClinicalTrials.gov (NCT03314311).

Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study

“…The Rehabilitation Strategies for Oesophageal Cancer (ReStOre) multi-disciplinary programme combines group resistance and aerobic exercise training with one-to-one dietary consultations and group education sessions over a 12-week period, with the aim to improve cardiovascular fitness and health-related QOL [ 24 ]. A feasibility study and pilot randomised controlled trial (RCT) of the ReStOre programme found it to be feasible, safe, and valuable to patients and to be effective in improving cardiovascular fitness without compromising body composition [ 23 , 25 , 26 , 27 , 28 ]. A larger RCT is now planned (ReStOre II RCT) to evaluate the intervention across a wider cohort of people with upper gastrointestinal cancer [ 24 ].…”