There is ample evidence supporting the positive impact of exercise on adverse effects of adjuvant cancer treatment. In the curative setting, exercise has shown positive results in patients undergoing breast cancer treatment in terms of reducing fatigue, but also in improving psychological symptoms, such as depression and low self-esteem. For metastatic breast cancer, the guidelines state that there is limited evidence on the potential effects of exercise and their recommendations are based on studies performed in the curative setting. Given the lack of alternatives for improving fatigue and the pressing unmet need to improve the quality of life of advanced cancer patients, exercise represents a promising and desirable intervention. Therefore, we started the PREFERABLE project.
PREFERABLE consists of two projects: EFFECT and PERSPECTIVE
The randomized EFFECT study aims to assess the effects of a structured and individualised exercise intervention in patients with metastatic breast cancer (stage IV) on cancer-related physical fatigue, Health-Related Quality of Life (HRQoL), and other disease and treatment-related side effects. The PERSPECTIVE study aims to explore the different perspectives of patients on exercise after a diagnosis of advanced breast cancer using a mixed-method design.
The primary EFFECT study has been completed. We found that exercise has beneficial effects on physical fitness, quality of life, fatigue, and other patient-reported outcomes (Hiensch et al. Nature Medicine 2024) and that exercise is cost-effective (Schouten et al. JCO 2025). Currently, we are investigating the long-term effects of the exercise intervention and barriers and facilitators for continuous exercise alongside the treatment of metastatic breast cancer.
