Cardiopulmonary exercise testing of patients with metastatic castrate-resistant prostate cancer as screening for vigorous exercise medicine prescription.

Newton, RU; Hart, NH; Kenfield, SA; Galvao, DA; Courneya, KS; Ryan, CM; Chan, JM; Catto, JWF; Winters-Stone, KM; Van Hemelrijck, M; Wylie, H; Schumann, M; Skinner, T; Praet, S; Saad, F

Cardiopulmonary exercise testing of patients with metastatic castrate-resistant prostate cancer as screening for vigorous exercise medicine prescription.

Newton, RU Hart, NH Kenfield, SA Galvao, DA Courneya, KS Ryan, CM Chan, JM Catto, JWF Winters-Stone, KM Van Hemelrijck, M Wylie, H Schumann, M Skinner, T Praet, S Saad, F

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Publisher:: American Society of Clinical Oncology (ASCO)
Publication Type:: Journal Article
Citation:: JCO Global Oncology, 2023, 9, (Supplement_1), pp. 80-80
Issue Date:: 2023-08

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Field	Value	Language
dc.contributor.author	Newton, RU
dc.contributor.author	Hart, NH
dc.contributor.author	Kenfield, SA
dc.contributor.author	Galvao, DA
dc.contributor.author	Courneya, KS
dc.contributor.author	Ryan, CM
dc.contributor.author	Chan, JM
dc.contributor.author	Catto, JWF
dc.contributor.author	Winters-Stone, KM
dc.contributor.author	Van Hemelrijck, M
dc.contributor.author	Wylie, H
dc.contributor.author	Schumann, M
dc.contributor.author	Skinner, T
dc.contributor.author	Praet, S
dc.contributor.author	Saad, F
dc.date.accessioned	2023-11-10T03:57:45Z
dc.date.available	2023-11-10T03:57:45Z
dc.date.issued	2023-08
dc.identifier.citation	JCO Global Oncology, 2023, 9, (Supplement_1), pp. 80-80
dc.identifier.issn	2687-8941
dc.identifier.issn	2687-8941
dc.identifier.uri	http://hdl.handle.net/10453/173311
dc.description.abstract	<jats:p> 80 </jats:p><jats:p> Background: Exercise is recommended for patients with prostate cancer to manage treatment adverse effects, improve quality of life and potentially influence cancer-specific outcomes. Men with advanced prostate cancer and metastatic disease may be at increased risk of cardiac events due to their cancer treatment and comorbidities. The aim of this study was to assess the safety and efficacy of cardiopulmonary exercise testing (CPET) for assessing cardiorespiratory capacity and risk screening of patients with metastatic castrate-resistant prostate cancer (mCRPC) prior to engaging in a vigorous program of exercise medicine. Methods: Experimental design was a cross-sectional analysis of screening CPET’s from a Phase III Randomised Controlled Trial (INTERVAL-GAP4) within the clinical setting involving men with mCRPC. Testing incorporated medically supervised, symptom limited, CPET with electrocardiogram (ECG) performed on a cycle ergometer until volitional exhaustion or maximal oxygen uptake peak (V0<jats:sub>2.PEAK</jats:sub>) attained. Outcome Measurements included safety (incidence and severity of adverse events), feasibility (completion of CPET) and efficacy (performance outcomes, screen-fails, and cardiac pathology). Descriptive statistics were calculated as mean and standard deviation. Results: 104 men (age 71.5 ± 8.4 years) with mCRPC completed a medically supervised CPET. Of these, 96 patients (92.3%) met the criterion for V0<jats:sub>2.PEAK</jats:sub> attainment and were randomised to the INTERVAL-GAP4 trial, with 8 (7.7%) CPET screen-fails. Four positive cardiac abnormalities (3.8%) were observed, with these patients referred to a cardiologist for further assessment. Referred patients were all cleared to participate in vigorous exercise with no clinically significant cardiovascular disease or were determined to have newly diagnosed and subsequently controlled cardiovascular disease. Average V0<jats:sub>2.PEAK </jats:sub>was 1.72 ± 0.51 L.min<jats:sup>-1</jats:sup> absolute and 18.96 ± 5.30 mL.kg<jats:sup>-1</jats:sup>.min<jats:sup>-1</jats:sup> relative which is in the 10-15<jats:sup>th</jats:sup> percentile for healthy men of this age. Maximal heart rate achieved was 141 ± 20 bpm at a maximal workload of 128 ± 40 W. There were no cardiac events or any other exercise-related adverse events during the testing. Conclusions: Maximal CPET is safe for men with advanced prostate cancer. CPET with ECG is also an effective cardiac stress screening tool prior to engaging in a vigorous exercise medicine program to detect underlying cardiovascular health issues. Further, results from CPET can be used to inform appropriate exercise prescription individualised to the patient. Clinical trial information: NCT02730338 . </jats:p>
dc.language	en
dc.publisher	American Society of Clinical Oncology (ASCO)
dc.relation.ispartof	JCO Global Oncology
dc.relation.isbasedon	10.1200/go.2023.9.supplement_1.80
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.title	Cardiopulmonary exercise testing of patients with metastatic castrate-resistant prostate cancer as screening for vigorous exercise medicine prescription.
dc.type	Journal Article
utslib.citation.volume	9
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - HPRC - Human Performance Research Centre
utslib.copyright.status	open_access	*
dc.date.updated	2023-11-10T03:57:44Z
pubs.issue	Supplement_1
pubs.publication-status	Published
pubs.volume	9
utslib.citation.issue	Supplement_1

Abstract:

80 Background: Exercise is recommended for patients with prostate cancer to manage treatment adverse effects, improve quality of life and potentially influence cancer-specific outcomes. Men with advanced prostate cancer and metastatic disease may be at increased risk of cardiac events due to their cancer treatment and comorbidities. The aim of this study was to assess the safety and efficacy of cardiopulmonary exercise testing (CPET) for assessing cardiorespiratory capacity and risk screening of patients with metastatic castrate-resistant prostate cancer (mCRPC) prior to engaging in a vigorous program of exercise medicine. Methods: Experimental design was a cross-sectional analysis of screening CPET’s from a Phase III Randomised Controlled Trial (INTERVAL-GAP4) within the clinical setting involving men with mCRPC. Testing incorporated medically supervised, symptom limited, CPET with electrocardiogram (ECG) performed on a cycle ergometer until volitional exhaustion or maximal oxygen uptake peak (V02.PEAK) attained. Outcome Measurements included safety (incidence and severity of adverse events), feasibility (completion of CPET) and efficacy (performance outcomes, screen-fails, and cardiac pathology). Descriptive statistics were calculated as mean and standard deviation. Results: 104 men (age 71.5 ± 8.4 years) with mCRPC completed a medically supervised CPET. Of these, 96 patients (92.3%) met the criterion for V02.PEAK attainment and were randomised to the INTERVAL-GAP4 trial, with 8 (7.7%) CPET screen-fails. Four positive cardiac abnormalities (3.8%) were observed, with these patients referred to a cardiologist for further assessment. Referred patients were all cleared to participate in vigorous exercise with no clinically significant cardiovascular disease or were determined to have newly diagnosed and subsequently controlled cardiovascular disease. Average V02.PEAK was 1.72 ± 0.51 L.min-1 absolute and 18.96 ± 5.30 mL.kg-1.min-1 relative which is in the 10-15th percentile for healthy men of this age. Maximal heart rate achieved was 141 ± 20 bpm at a maximal workload of 128 ± 40 W. There were no cardiac events or any other exercise-related adverse events during the testing. Conclusions: Maximal CPET is safe for men with advanced prostate cancer. CPET with ECG is also an effective cardiac stress screening tool prior to engaging in a vigorous exercise medicine program to detect underlying cardiovascular health issues. Further, results from CPET can be used to inform appropriate exercise prescription individualised to the patient. Clinical trial information: NCT02730338 .

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