title: EXercise to prevent AnthrCycline-based Cardio-Toxicity (EXACT) in individuals with breast or hematological cancers: a feasibility study protocol.
abstract: BACKGROUND
  Anthracyclines (AC), widely used and effective anticancer agents, are known to induce both acute and chronic declines in cardiovascular health, ranging in severity from asymptomatic, subclinical dysfunction to substantial cardiomyopathy leading to congestive heart failure and death. There is substantial evidence that physical activity, higher levels of cardiorespiratory fitness, and exercise therapy can help prevent cardiovascular disease. Moreover, animal studies have shown that exercise performed concomitantly with AC treatment may attenuate early cardiac damage that results from AC exposure. Our primary objective is to assess the feasibility of a 12-week aerobic exercise training (AET) program in patients receiving AC-based chemotherapy.
  
  
  METHODS
  This is a prospective, single-arm (pre-post-test design), feasibility study of a supervised 12-week progressive, light-to-moderate to moderate-to-vigorous intensity AET program for patients (18-65 years) receiving AC chemotherapeutic treatment for a primary/non-recurrent breast cancer or hematological malignancy. Both feasibility (e.g., participant recruitment, program adherence, safety) and intervention outcome (e.g., biological markers of cardiotoxicity, aerobic capacity, quality of life) measures will be collected. The AET program will include two, 45-min community-based exercise sessions (treadmill or cycle) per week for a total of 12 weeks. All exercise sessions will be supervised by trained exercise specialists.
  
  
  CONCLUSIONS
  Data from the EXACT study will be evaluated to determine the need to refine patient recruitment methods and general acceptability of the AET program. Preliminary data on the effects of the AET intervention on pertinent cardiac and health outcomes will also be evaluated and used to inform future studies in terms of the most appropriate outcome measure(s) to adopt and sample size estimation.
  
  
  BACKGROUND
  ClinicalTrails.gov, NCT02471053.
authors.affiliation: School of Health and Human Performance (Kinesiology), Dalhousie University, PO Box 15000, 6230 South Street, Halifax, Nova Scotia B3H 4R2 Canada.
authors.forename: Melanie R
authors.initials: MR
authors.lastname: Keats
authors.affiliation: School of Health and Human Performance (Kinesiology), Dalhousie University, PO Box 15000, 6230 South Street, Halifax, Nova Scotia B3H 4R2 Canada.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Grandy
authors.affiliation: Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada ; QEII Health Sciences Center-HI Site, Suite 2261-1796 Summer St., Halifax, Nova Scotia B3H 3A6 Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Giacomantonio
authors.affiliation: Division of Hematology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada ; QEII Health Sciences Center, 1276 South Part Street, Halifax, Nova Scotia B3H 2Y9 Canada.
authors.forename: David
authors.initials: D
authors.lastname: MacDonald
authors.affiliation: Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada ; QEII Health Sciences Center-HI Site, Suite 2261-1796 Summer St., Halifax, Nova Scotia B3H 3A6 Canada.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Rajda
authors.affiliation: Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada ; QEII Health Sciences Center, 1276 South Part Street, Halifax, Nova Scotia B3H 2Y9 Canada.
authors.forename: Tallal
authors.initials: T
authors.lastname: Younis
keywords: Aerobic exercise training; Anthracyclines; Breast cancer; Cardiotoxicity; Feasibility study; Hematological cancer