Physical activity interventions for women with metastatic breast cancer: a systematic review of published and ongoing randomised controlled trials

Purpose

We systematically reviewed published and ongoing physical activity (PA) trials in women with metastatic breast cancer (MBC). We examined (i) the effectiveness of PA interventions and identified (ii) the type of interventions being evaluated, (iii) how they are delivered and (iv) their theoretical basis.

Methods

Seven databases and two trial registries were searched in August 2024 for randomised controlled trials, testing any PA intervention in people with MBC, reporting a PA outcome. The Joanna Briggs Institute (JBI) handbook was followed, including quality assessment using the JBI Critical Appraisal Checklist for RCTs. Data were summarised narratively. Intervention details were extracted using the TIDieR framework.

Results

One thousand six hundred eighty-seven records were screened and 96 assessed for eligibility. Twenty-eight reports were included (13 full reports, 4 protocols, 11 trial registries). Sample sizes ranged from 21 to 357 participants. Twentyone out of 28 reports were phase II, pilot, or feasibility trials. Most interventions did not cover all types of recommended PA. The methodological quality of studies was moderate. Intervention adherence was moderate to high (≥50% in 10 studies). Among studies reporting on safety (9), only one recorded any serious events (two events) related to the intervention. Evidence indicates that PA can improve fatigue, health-related QoL, physical fitness, and functioning over the short and medium term (≤6 months).

Conclusions

Physical activity is safe, well adhered to, and improves physical function and QoL in MBC. Future trials could clarify the optimal PA type, duration, delivery mode, and long-term effectiveness.

Implications for Cancer Survivors

Women with MBC should be supported by healthcare professionals to be active.