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Physical exercise effects on metastasis: a systematic review and meta-analysis in animal cancer models

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Abstract

Physical exercise is considered a well-tolerated adjuvant therapy to mitigate cancer-related side effects, but its impact on metastasis is unclear. The present systematic review and meta-analysis aimed to summarize the evidence on the effects of exercise on metastasis in animal cancer models. A systematic search was conducted to identify controlled studies in animals analyzing the impact of exercise interventions on any marker of metastasis incidence or severity. The pooled mean differences (PMD) were calculated for those endpoints for which a minimum of three studies used the same assessment method. We also calculated the pooled odds ratio (OR) of metastases. Twenty-six articles were included in the systematic review, of which 12 could be meta-analyzed. Exercise training in murine cancer models did not significantly modify the number of metastatic foci (PMD = − 3.18; 95% confidence interval [CI] − 8.32, 1.97; p = 0.23), the weight of metastatic tumors (PMD = − 0.03; 95% CI − 0.10, 0.04; p = 0.41), or the risk of developing metastasis (OR = 0.64; 95% CI 0.10, 4.12; p = 0.64). These findings suggest that exercise has no overall influence on any marker of cancer metastasis incidence or severity in animal models. However, the wide methodological heterogeneity observed between studies might be taken into account and the potential exercise effects on metastasis development remain to be determined in pediatric tumors.

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Funding

Research by the authors is supported by the Spanish Ministry of Education, Culture and Sport [Javier S. Morales, contract #FPU14/03435, and Cecilia Rincón-Castanedo, contract #FPU16/03956]; Universidad de Alcalá [Pedro L. Valenzuela, contract #FPI2016]; the Spanish Ministry of Economy and Competitiveness and Fondos Feder [Alejandro Lucia, grant #PI15/00558 and PI18/00139]; the Spanish Ministry of Economy and Competitiveness [Miguel Servet research contract (Carmen Fiuza-Luces, ref. #CP18/00034)]; ‘Fundación Unoentrecienmil’; ‘Fundación MAPFRE’ [Convocatoria Ignacio H. de Larramendi]; and National Strength and Conditioning Association (NCSA) Foundation.

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Author notes

  1. Cecilia Rincón Castanedo and Javier S. Morales contributed equally to this work.

Authors and Affiliations

  1. Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain

    Cecilia Rincón-Castanedo, Javier S. Morales, Asunción Martín-Ruiz & Alejandro Lucia

  2. Department of Systems Biology, University of Alcalá, Madrid, Spain

    Pedro L. Valenzuela

  3. Unidad de Terapias Avanzadas, Servicio de Oncohematología, Hospital Universitario Niño Jesús, Madrid, Spain

    Manuel Ramírez

  4. i+HeALTH, Department of Health Science, European University Miguel de Cervantes, Valladolid, Spain

    Alejandro Santos-Lozano

  5. Laboratorio en Actividad Física y Salud, Instituto de Investigación Hospital Universitario 12 de Octubre (i+12), Avenida de Córdoba s/n, 28041, Madrid, Spain

    Alejandro Santos-Lozano, Alejandro Lucia & Carmen Fiuza-Luces

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Rincón-Castanedo, C., Morales, J.S., Martín-Ruiz, A. et al. Physical exercise effects on metastasis: a systematic review and meta-analysis in animal cancer models. Cancer Metastasis Rev 39, 91–114 (2020). https://doi.org/10.1007/s10555-020-09851-4

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  • DOI: https://doi.org/10.1007/s10555-020-09851-4

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