Exercise for the mitigation of cancer therapy-related cardiac dysfunction in breast cancer patients treated with anthracyclines: a systematic review and meta-analysis
In brief
Exercise halves the rise in cardiac troponin I during anthracycline therapy
In a meta-analysis of six randomized trials with 360 breast-cancer patients, a supervised exercise program of at least 12 weeks reduced the chemotherapy-induced increase in cardiac troponin I by roughly 50% compared with usual care. No clear benefit was seen for ejection fraction or other cardiac markers, so larger trials are needed to confirm whether exercise truly protects heart function during anthracycline treatment.
- Journal
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Q1)
- Published
- 3 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Alejandro Jiménez Marín, María Virginia García-Coll, Evelyn Martín Moraleda, Mónica Castellanos-Montealegre, Susana Aznar Laín
- PMID
- 42690445
- DOI
- 10.1007/s00520-026-11085-z
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (top studies of the week, 6 September 2026): Exercise for anthracycline cardiotoxicity in breast cancer, medical oncology focus
Abstract
PURPOSE: Cancer therapy-related cardiac dysfunction (CTRCD) is a significant concern for breast cancer patients undergoing anthracycline-based chemotherapy. Although exercise has been proposed as a cardioprotective strategy, existing reviews have largely examined heterogeneous cancer populations receiving varied treatments, leaving a gap in the evidence base focused exclusively on anthracycline-induced CTRCD. This systematic review and meta-analysis aimed to address that gap by evaluating the effects of long-term exercise on key CTRCD markers in breast cancer patients treated exclusively with anthracyclines. METHODS: A comprehensive search of PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science was conducted for randomized controlled trials including breast cancer patients undergoing anthracycline-based chemotherapy, receiving long-term exercise interventions (≥ 12 weeks, ≥ 1 session/week) compared to usual cancer care, and reporting at least one of the following outcomes: left ventricular ejection fraction, global longitudinal strain, cardiac troponin I, cardiac troponin T, or N-terminal prohormone of brain natriuretic peptide. RESULTS: Six randomized controlled trials involving 360 participants were included. Exercise significantly attenuated cardiac troponin I elevation compared to controls (SMD = -0.50; 95% CI, -0.93 to -0.06; p = 0.02). No statistically significant between-group differences were observed for left ventricular ejection fraction, global longitudinal strain, cardiac troponin T, or N-terminal prohormone of brain natriuretic peptide. CONCLUSION: The cardioprotective role of exercise during anthracycline treatment remains uncertain, though the attenuation of cardiac troponin I elevation suggests a potential protective signal warranting further investigation through larger, standardized trials employing advanced assessment modalities and longer follow-up periods.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.