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Association between physical activity and neoadjuvant chemotherapy completion and pathologic complete response in primary breast cancer: the CANTO study



Regular physical activity is associated with improved symptom control in patients with breast cancer but its association with chemotherapy completion or response is unclear.


Using a prospective design, 1075 breast cancer patients receiving neoadjuvant chemotherapy between March 2012 and February 2017 were studied. Physical activity was assessed using the Global Physical Activity Questionnaire [GPAQ-16], quantified in standardised MET-h/wk. Chemotherapy completion was defined as the proportion of patients completing planned treatment course, requiring dose reduction, or requiring dose delay. Response was evaluated by pathologic complete response (pCR). Associations between physical activity and primary outcomes were assessed using multivariable logistic regression models.


There was no differences between any chemotherapy completion outcome on the basis of physical activity classification. The percent of patients not completing planned treatment was 5.7% for 0.33 MET-h/wk, compared with 6.8% for 0.34–16.65 MET-h/wk, and 4.6% for ≥16.6 MET-h/wk (p = 0.52). No significant relationships were observed between physical activity dose classification and pCR for the overall cohort or upon stratification by clinical subtype.


Future studies are required to further investigate the relationship between pre-treatment levels of physical activity and function on treatment completion and response in breast and other cancer populations.

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An interim analysis from this study was presented at the San Antonio Breast Cancer Symposium 2018, Dec 4–8, San Antonio, TX.


CANTO is funded by Agence Nationale de la Recherche (ANR-10-COHO-0004). IV-L received support from Odyssea, Foundation Gustave Roussy, and CCR17483507 Career Catalyst Research grant. ADM received support from Susan G. Komen, Clinical Research Fellowship from ESMO. LWJ is supported in part by funding from the National Cancer Institute, AKTIV Against Cancer, the KavliTrust, and the Memorial Sloan Kettering Cancer Center Support Grant/Core Grant (P30 CA008748).

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Authors and Affiliations



JLB: Wrote the paper. ADM, ASG, MEM: Conceived and designed the analysis and performed the analysis. NMI: Conceived and designed the analysis. SM, PC, FL, CC, AL, OT, LV, CJ, IH, SE, A-LM, PA, AF: Collected the data. IV-L, LWJ: Conceived and designed the analysis and wrote the paper.

Corresponding authors

Correspondence to Ines Vaz-Luis or Lee W. Jones.

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Competing interests

LWJ owns stock in Pacylex, Inc. and Illumisonics, Inc. IV-L reports personal fees from AstraZeneca, Kephren, Amgen, and Novartis. ADM reports personal fees from Thermo Fisher and grants from European Society for Medical Oncology (ESMO), fellowship support, outside the submitted work.

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Informed consent was obtained from all patients prior to study participation at each institution.

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Baker, J.L., Di Meglio, A., Gbenou, A.S. et al. Association between physical activity and neoadjuvant chemotherapy completion and pathologic complete response in primary breast cancer: the CANTO study. Br J Cancer (2022).

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