title: Effects of aerobic exercise training in anemic cancer patients receiving darbepoetin alfa: a randomized controlled trial.
abstract: BACKGROUND
  Anemia in patients with solid tumors is a common problem that is associated with impaired exercise capacity, increased fatigue, and lower quality of life (QoL). Erythropoiesis-stimulating agents (ESAs) have been shown to improve these outcomes; however, it is unknown if additional benefits can be achieved with aerobic exercise training.
  
  
  METHODS
  We conducted a single-center, prospective, randomized, controlled trial in 55 mild-to-moderately anemic patients with solid tumors. Patients were randomized to either darbepoetin alfa alone (DAL, n = 29) or darbepoetin alfa plus aerobic exercise training (DEX; n = 26). The DEX group performed aerobic exercise training three times per week at 60%-100% of baseline exercise capacity for 12 weeks. The primary endpoint was QoL assessed by the Functional Assessment of Cancer Therapy-Anemia scale. Secondary endpoints were fatigue, cardiorespiratory fitness (VO(2peak)), hemoglobin (Hb) response, and darbepoetin alfa dosing.
  
  
  RESULTS
  Intention-to-treat analyses indicated significant improvements in QoL and fatigue in both groups over time but there were no between-group differences. The DEX group had a significantly greater VO(2peak) than the DAL group (mean group difference, +3.0 ml/kg per minute; 95% confidence interval, 1.2-4.7; p = .001) and there were borderline significant differences in favor of the DEX group for Hb response and darbepoetin alfa dosing.
  
  
  CONCLUSIONS
  Aerobic exercise training did not improve QoL or fatigue beyond the established benefits of DAL but it did result in favorable improvements in exercise capacity and a more rapid Hb response with lower dosing requirements. Our results may be useful to clinicians despite the more recent restrictions on the indications for ESAs.
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Peddle
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Sellar
authors.forename: Tony
authors.initials: T
authors.lastname: Reiman
authors.forename: Anil A
authors.initials: AA
authors.lastname: Joy
authors.forename: Neil
authors.initials: N
authors.lastname: Chua
authors.forename: Linda
authors.initials: L
authors.lastname: Tkachuk
authors.forename: John R
authors.initials: JR
authors.lastname: Mackey
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D000068256:Darbepoetin alfa; D004311:Double-Blind Method; D004921:Erythropoietin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D004921:Erythropoietin; D000068256:Darbepoetin alfa