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  • Perspective
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The effect of physical exercise on anticancer immunity

Nature Reviews Immunology volume 24, pages 282–293 (2024)Cite this article

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An Author Correction to this article was published on 01 February 2024

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Abstract

Regular physical activity is associated with lower cancer incidence and mortality, as well as with a lower rate of tumour recurrence. The epidemiological evidence is supported by preclinical studies in animal models showing that regular exercise delays the progression of cancer, including highly aggressive malignancies. Although the mechanisms underlying the antitumorigenic effects of exercise remain to be defined, an improvement in cancer immunosurveillance is likely important, with different immune cell subtypes stimulated by exercise to infiltrate tumours. There is also evidence that immune cells from blood collected after an exercise bout could be used as adoptive cell therapy for cancer. In this Perspective, we address the importance of muscular activity for maintaining a healthy immune system and discuss the effects of a single bout of exercise (that is, ‘acute’ exercise) and those of ‘regular’ exercise (that is, repeated bouts) on anticancer immunity, including tumour infiltrates. We also address the postulated mechanisms and the clinical implications of this emerging area of research.

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Fig. 1: The biphasic immune cell response to dynamic (such as bicycling and running), acute exercise.
Fig. 2: The immune cell response to regular exercise (that is, accumulation of repeated exercise bouts).
Fig. 3: Regular exercise has the potential to ‘heat’ tumours.

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Acknowledgements

The authors are grateful to K. McCreath for helpful comments on the text. Research by A.L. and C.F.-L. in exercise and cancer is funded by the Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant programme (grant number IIG_FULL_2021_007), and the Spanish Ministry of Science and Innovation (Fondo de Investigaciones Sanitarias (FIS)) and Fondos FEDER (grant numbers PI18/00139 and PI20/00645), and European Union’s Horizon 2020 research and innovation programme under grant agreement number 945153. Research by C.F.-L. is funded by a Miguel Servet postdoctoral contract granted by Instituto de Salud Carlos III (CP18/00034). Research by P.L.V. is funded by a Sara Borrell postdoctoral contract granted by Instituto de Salud Carlos III (CD21/00138).

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Authors and Affiliations

  1. Physical Activity and Health Research Group (‘PaHerg’), Research Institute of the Hospital 12 de Octubre (‘imas12’), Madrid, Spain

    Carmen Fiuza-Luces, Pedro L. Valenzuela & Beatriz G. Gálvez

  2. Systems Biology Department, Universidad de Alcalá, Alcalá de Henares, Spain

    Pedro L. Valenzuela

  3. Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid, Spain

    Beatriz G. Gálvez

  4. Oncohematology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain

    Manuel Ramírez

  5. Biomedical Research Foundation, Hospital Infantil Universitario Niño Jesús, Madrid, Spain

    Manuel Ramírez

  6. La Princesa Institute of Heah, Madrid, Spain

    Manuel Ramírez

  7. Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain

    Alejandro López-Soto

  8. Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Asturias, Spain

    Alejandro López-Soto

  9. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain

    Alejandro López-Soto

  10. School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, USA

    Richard J. Simpson

  11. Department of Paediatrics, The University of Arizona, Tucson, AZ, USA

    Richard J. Simpson

  12. Department of Immunobiology, The University of Arizona, Tucson, AZ, USA

    Richard J. Simpson

  13. CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain

    Alejandro Lucia

  14. Faculty of Sport Sciences, Universidad Europea, Madrid, Spain

    Alejandro Lucia

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  1. Carmen Fiuza-Luces
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Contributions

A.L. wrote the first manuscript draft with the help of C.F.-L. All authors researched data for the article, contributed to the discussion of content, and also reviewed and edited the article in depth before submission. B.G.G. and C.F.-L. made the figures.

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Correspondence to Carmen Fiuza-Luces, Alejandro López-Soto or Alejandro Lucia.

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Nature Reviews Immunology thanks Bente Klarlund Pedersen, Karsten Krueger and John P. Campbell for their contribution to the peer review of this work.

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Glossary

Exercise (or ‘exercise training’)

A form of structured leisure-time physical activity with the purpose of improving or maintaining health — training for a 10-km running race, or resistance training (for example, weight lifting) to increase muscle mass. Although physical activity and exercise are often used interchangeably, the bulk of observational epidemiological evidence is based on physical activity data, whereas exercise is frequently used in intervention trials and preclinical studies.

Physical activity

Any bodily movement produced by skeletal muscles that requires energy expenditure and includes the domains of occupational, domestic, transportation and leisure time (such as walking to work or walking the dog).

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Fiuza-Luces, C., Valenzuela, P.L., Gálvez, B.G. et al. The effect of physical exercise on anticancer immunity. Nat Rev Immunol 24, 282–293 (2024). https://doi.org/10.1038/s41577-023-00943-0

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