The results of our randomized controlled clinical trial are excellent news for people with metastatic breast cancer. It shows that they can experience a significantly better quality of life with significantly less fatigue; they can also have less pain and other disease symptoms and treatment side-effects if they take part in a supervised exercise programme as part of their treatment.

To share these results, our partners at Europa Donna have now created a brochure. In this brochure you can find out more about the PREFERABLE Project and what the results mean for people with MBC.

Our project’s closing event took place on June 29^th, 2024, during the MASCC conference in Lille. During our symposium, the effects of the intervention on fatigue and quality life, were presented. Also, we presented the found effects on physical and social functioning, and reductions in pain, dyspnea, and sexual health issues in patients who did the exercise intervention.

Additionally, we have shared the key findings regarding patients’ perspectives. Importantly, we also invited a study participant to share her experiences and she highlighted how the exercise intervention has significantly improved her quality of life. Her heartfelt testimony moved the audience, illustrating the profound personal impact of our project. The workshop was concluded with a fruitful panel discussion on the implementation of exercise for patients with mBC in the European healthcare setting.

The audience of the MASCC conference consists of, amongst others, clinicians, scientists, physical therapists, psychologists, and patients. We had also invited policy makers. Therefore, we are confident that our closing event has contributed to disseminating our project results in a broad range of stakeholder groups and will thereby support convincing different stakeholders of the importance of the work carried out in the project and ensure optimal uptake of the results into clinical practice

Is a 9-month exercise program for patients with metastatic breast cancer likely to be cost-effective? Yes!

At the American Society of Clinical Oncology (ASCO) annual meeting in Chicago we presented results of the PREFERABLE-EFFECT study. The results show that exercise effectively reduces side effects of patients with metastatic breast cancer and reduces healthcare and societal costs!

Last week, we presented the PREFERABLE project results at the ACSM24 conference in Boston.

In a quick oral session, we talked about the challenges and benefits of including exercise in regular cancer care across Europe. During a poster session, we showed how the 9-month EFFECT exercise program improves fitness and physical performance in patients with metastatic breast cancer.

We also shared PREFERABLE results in a symposium on exercise and metastatic disease, showing the project’s important impact in this area.

Additionally, we were invited to the Harvard Medical School Dana-Farber Cancer Institute to discuss our exercise-oncology studies from UMC Utrecht Cancer Research, UMC Utrecht, and the Julius Center Research Program Cancer at UMC Utrecht.

It was a fantastic week, and we were happy to reconnect with many members of the PREFERABLE Consortium.

The PREFERABLE II Consortium was well represented during the ISEO pre-conference at the American College of Sports Medicine (ACSM) Annual Meeting 2024. This pre-conference was organized to discuss about the possibility and potential benefits of forming a new organization: the International Society of Exercise Oncology(ISEO). Anne May presented the PREFERABLE studies as example of successful multinational exercise oncology RCTs, showing that teamwork makes the dream work.

The PREFERABLE project made a significant impact at this year’s ESMO Breast Conference, which took place from May 15-17 in Berlin.

The ESMO Breast Conference is a large event where experts from around the world gather to share the latest research and advancements in breast cancer treatment. It’s an important platform for discussing new findings, innovative treatments, and improving patient care.

Dr. Martina Smith shared some important results about how exercising can positively impact sexual health in patients with advances breast cancer, bringing attention to an often overlooked aspect of patient care. You can read more on this short article written by the daily reporter.

Project coordinator Anne May highlighted PREFERABLE in the ESMO breast key takeaways, where she emphasized the project’s significant role in improving patients’ well-being.

Anne May, Lead Researcher for the PREFERABLE project, shared promising results from the PREFERABLE-EFFECT study, where Europa Donna (ED) is involved as a partner. She presented that twice-weekly supervised exercise sessions significantly improved quality of life and reduced fatigue in patients with metastatic breast cancer (MBC). She also shared that our program helped reduce pain and shortness of breath, proving to be safe and effective with a median attendance of 77% and no exercise-related injuries.

Participants experiences were also shared. For example, one participant shared her journey from struggling with warm-ups to being able to garden and play with her grandchildren after three months. Anne May concluded with an interview featuring a patient advocate from Europa Donna UK, asking her about her thoughts on the results and her own exercise experiences. The patient advocate highlighted the benefits of exercising with a buddy as a golden tip for staying motivated.

This Wednesday, Anouk Hiensch from UMCU presented the findings of the PREFERABLE-EFFECT study at the 14th European Breast Cancer Conference in Milan. In the Young Investigator Innovation Award and Oral Abstracts session she presented whether the positive effects of exercise on fatigue and quality of life apply to all patients with metastatic breast cancer. It was a very interesting and multidisciplinary conference and we would like to thank the organizers and Europe Donna.

During our 11th consortium meeting in Stockholm, we started off with a presentation on the cost-effectiveness of the exercise intervention. This is a very important analysis for future implementation and potential reimbursement of the intervention. In addition, exciting first (preliminary) results from our blood analysis were shared. We will work more on these analyses during the final months of the project.

In the afternoon, the entire consortium collaborated to formulate recommendations for different groups of stakeholders such as policy makers, healthcare managers, and exercise professionals. The recommendations are based on the found effects of supervised exercise in patients with metastatic breast cancer (MBC), but also on our research on patients’ perspectives on exercising after diagnosis and interviews with different stakeholder groups. We consider it very important to we work on integrating these exercise recommendations into clinical guidelines and to facilitate the implementation of exercise programs into routine clinical care. 

We are delighted to announce the presentation of final results of the PREFERABLE project during a workshop, at the MASCC congress in Lille on June 29th 2024! 

PREFERABLE-EFFECT is the first large international RCT investigating the effect of supervised exercise in patients with metastatic breast cancer. The consortium also investigated the different perspectives of patients on exercise after a diagnosis of metastatic breast cancer using a mixed method design (i.e., focus groups and questionnaires), the PREFERABLE-PERSPECTIVE study. The ultimate goal of the PREFERABLE project is to deliver a strategy that enables implementation of exercise interventions into clinical guidelines. 

During the final symposium, beneficial effects of the exercise intervention on the primary outcomes, fatigue and quality life, will be presented as well as effects on other outcomes. Additionally, a study participant will share her experiences and tell how exercise changed her life. We will also delve into the key findings regarding patient perspectives. Renowned guest speakers, like Kathryn Schmidt, Nicolas Hart, and Anna Campbell, will present their view on the outcomes of Preferable-EFFECT. The workshop will conclude with a panel discussion on implementation of exercise for patients with metastatic breast cancer in the European Healthcare system. 

Following the San Antonio Breast Cancer Symposium, the ASCO post has written a nice article on the results of the Preferable project: Patients With Advanced Breast Cancer May Gain Multiple Benefits From Exercise as Part of Palliative Care. The full article can be read here. 

The first results from the PREFERABLE-EFFECT trial were unveiled at the San Antonio Breast Cancer Symposium (SABCS), held December 5-9, 2023.  Anne May gave a presentation to a large audience and additionally explained more about the findings in a press conference, in which 3 specific abstracts (out of the 1900 abstracts submitted) were chosen to be discussed. In this video (in German) you can get an impression of the day and what the PREFERABLE-EFFECT trial looked like.

We enrolled 357 patients with metastatic breast cancer to the PREFERABLE-EFFECT trial, a collaboration between institutions in Germany, Poland, Spain, Sweden, the Netherlands, and Australia. The outcomes of this trial showed that those who took part in our nine-month structured exercise program reported less fatigue compared to those who did not undergo the exercise program. Also, those assigned to the exercise intervention reported an improved quality of life, including an increase in social functioning, decrease in pain, and decrease in shortness of breath.

In addition, we found that the nine-month intervention was not only effective but may have encouraged longer-term compliance as well. Based on these findings, we suggest that physicians and nurses should routinely recommend supervised exercise to patients with metastatic breast cancer and that policymakers and insurance companies should ensure cost coverage for exercise programs.

For the full press release, please check our publications. You can also read more on the ASCO Post.

EUROPA DONNA’S 16th Pan-European Conference provided participants with the latest information and tools to help them break barriers in breast cancer advocacy in their countries. Covered topics range from surgery and radiation to genetic testing. At the conference, Anne May presented the general evidence on the effect of exercise in oncology and provided an update on the PREFERABLE project.

On the 9^th and 10^th of October we met in Amsterdam for the 10^th PREFERABLE Consortium Meeting. We discussed new findings following the analysis of the available data. We did not only look at the clinical data but also presented findings on the cost-effectiveness of the EFFECT trial. In addition, we made plans for our research on the blood samples. We expect the first publication of our results at the end of 2023 or the beginning of 2024. When these results are final we will of course inform all of the participants and health care professionals that have contributed to the project.

On the 14^th and 15^th of September, 2023, the International Conference on Physiotherapy in Oncology (ICPTO) ‘Advances in providing the best care’ took place in Amsterdam.

Martijn Stuiver, also founder of the ICPTO conference, presented results from the PERSPECTIVE survey and focus groups. He discussed the preferences, barriers and facilitators for exercise interventions and stressed the importance of offering a helping hand to cancer survivors when engaging in exercise: when should exercise be implemented, provide a personalized advise and ensure easy accessible training facilities.

Anne May discussed whether the benefits of exercise outweigh the costs. She concluded that the current state of evidence on the cost-effectiveness of exercise programs for cancer survivors is very scarce and inconclusive. More research, and specifically on the cost-effectiveness of exercise, is needed to get exercise implemented. In addition, she presented preliminary results of the interviews that were conducted to get insight in the barriers and facilitators of integrating exercise in European Healthcare systems and health insurance systems.

Martijn Stuiver presented the results of the PERSPECTIVE focus group and survey studies at the world congress of the International Psycho Oncology Society, in Milan. In a session on cancer treatment-related symptoms and toxicity management, the implications of PERSPECTIVE’s findings for implementation of exercise for patients with metastasized breast cancer, and for patient education, were discussed with the multidisciplinary audience.

On the 4th and 5^th of May the PREFERABLE consortium met in Heidelberg. We had an exciting first view on the primary results of the EFFECT trial and plans were made for further analyses and dissemination of the results. The analyses of the blood samples and economic implications can now also be completed. Also, the data from the PERSPECTIVE study keeps on providing valuable insights and dissemination is in progress.

The Preferable researchers are already expanding their research on exercise in cancer, and recently the Preferable-II project has started. On 26th April 2023, the PREFERABLE-II project held a one-hour event at the EU Parliament to discuss the implementation of personalised live-remote exercise-oncology for improvement of supportive care. The launch event aimed to present the project and its research goals to policy makers and was attended by medical professionals, research specialists, patient associations, and policy-makers.

Results and experiences from PREFERABLE were shared at the European Society for Medical Oncology (ESMO) Congress in Paris, 9-13 September 2022.

Maike Sweegers presented results from the exercise-oncology PERSPECTIVE survey. Patients with mBC are positive about exercise, but need help with the execution: when implementing exercise, attention should be given to personalized advice & easy accessible training facilities.

Johanna Depenbusch presented results from PERSPECTIVE via a poster with results from the focus groups in four countries on what are preferences, facilitators and barriers for exercise intervention.

And Karen Steindorf, also member of the ESMO 2022 organizing committee, indicated the importance of the PREFERABLE project in the context of her ESMO educational session about the management of fatigue.

On the 8th & 9th of September we met in Paris (+ online) for the 8th PREFERABLE Consortium Meeting. We celebrated the completion of the inclusion for EFFECT trial. The trial will be finalized approximately May-June 2023. We also discussed the analyses of the PERSPECTIVE surveys and focus groups and what questions we need to ask the experts for the healthcare system analysis to eventually come to usefull recommendations. With this progress, we were able to make more concrete plans for how to effectively share our knowledge and future recommendations.

We have reached our target of 350 patient inclusions in the PREFERABLE EFFECT study! Next year we will have the initial results about the effects of personalized exercise on fatigue and quality of life in patients with metastatic breast cancer.

The design of the EFFECT trial was published in the magazine Trials in July 2022. In the publication, members of the PREFERABLE consortium explain the setup of the trial. The full publication can be found here: Design of a multinational randomized controlled trial to assess the effects of structured and individualized exercise in patients with metastatic breast cancer on fatigue and quality of life: the EFFECT study – PubMed (nih.gov).

On the 9th & 10th of May we met in Stockholm (+ online) for the 7th PREFERABLE Consortium Meeting. Initial results of the PERSPECTIVE surveys and focus groups were discussed and we expect to complete the inclusion for EFFECT in the coming months. We made further preparations for the analysis of the data of the studies as well as the plans for the healthcare system analysis, including cost-effectiveness. In addition, Nurogames provided an interesting overview of the developments in the field of exergaming.

On the picture one of the participants in Spain (with permission).

Thursday (28th of October), our PREFERABLE colleague Anouk Hiensch successfully defended her thesis entitled ‘Stepping stones to implement exercise as integral part of cancer care’.

You can access her thesis via this link: Publicatie Online :: PDF (publicatie-online.nl) using this accesscode: ProefschriftAnouk or have a look at her pitch: Videopitch Anouk Hiensch – YouTube

We finally met in person again during our 6th PREFERABLE Consortium Meeting in San Sebastian. Recruitment for both the EFFECT and PERSPECTIVE studies is still ongoing, but will be finalized in 2022. Both days were very productive and full of good discussions. We are looking forward to the next Consortium Meeting that will take place in spring 2022.

We are now halfway through recruiting patients for the EFFECT study! This week, the 175th participant agreed to participate in the study. As a result, we have reached the EU-milestone. A big thanks to all participants and staff, who are all highly committed to the project.

Due to the Corona pandemic, Poland only started recruitment in March. They already recruited the 10th participant by the end of August. Keep up the good work! In the meanwhile, all sites are up and running and we hope to be halfway through recruitment very soon.

The team of Onkologikoa in San Sebastian, Spain, had the honor of including the 100th patient in the EFFECT trial.
In addition, the first few patients have been included in Poland, which means that all countries are now recruiting.

After a year of lockdowns and slow recruitment due to COVID-19 restrictions, we are very glad to announce that almost all sites are now recruiting for the EFFECT trial. In addition to recruitment in the Netherlands, Germany, Spain and Sweden, recruitment has now also started at an additional site in Germany (Cologne) and in Australia. And last but least, Poland is expected to start very soon as well. To date 82 participants, of the 350 to be included, have started in the trial worldwide.

(Picture is used with participant’s permission)

We are very happy to announce that patient recruitment for the EFFECT trial is progressing! Most sites were able to take measures to deal with the COVID-19 related restrictions and recruitment has been restarted. Off course, challenges remain but we are grateful that we can offer a place to most women now who are willing to join.

Due to the COVID-19 pandemic, the patient  recruitment for the EFFECT trial has been put on hold. All patients who were already included stopped exercising at a physiotherapy centre and will continue when they are allowed to. In the meantime, patients will perform home-based exercise.

During the first day last preparations have been made successfully to start recruitment for the EFFECT trial in all centers. The second day was dedicated to the PERSPECTIVE study: The consortium had interactive sessions in preparation of the focus groups.

On 5th and 6th September 2019 the consortium met at the German Sport University Cologne to prepare the EFFECT and PERSPECTIVE studies. Both days were very productive and full of good discussions, starting with a refreshing early morning run. We are excited to include our first patients soon and look forward to our next consortium meeting that will take place in Gdańsk, Poland, in Spring 2020.

PREFERABLE researchers Dr. Anne May (UMCU) and Prof. Dr. Karen Steindorf (DKFZ) have been invited by consortium member Europa Donna to present at their 2^nd MBC advocacy conference in Milan, Italy. They presented on “Benefits of Physical Activity for women with MBC” (Karen) and “Apps for MBC: overview of what’s available and how they work; new one in development (PREFERABLE)” (Anne).

PREFERABLE’s consortium members and advisors attended the 66th annual meeting of the American College of Sports Medicine (ACSM) in Orlando, Florida, USA. ACSM’s annual meeting brings together science and practice with leading experts and latest research on sports medicine and exercise oncology.

The official launch of the PREFERABLE project took place on 10^th and 11^th January 2019. All project partners met in the University Medical Center Utrecht, NL, that is coordinator of the project. The consortium was introduced and all scientific, administrative and financial tasks and activities of the project have been discussed constructively. The two days were very successful and all partners are enthusiastic to implement PREFERABLE.

As the coordinator of the project UMC Utrecht attended the H2020 Coordinator’s Day in Brussels. All 10 coordinators from 5 countries who received funding within the H2020 call ‘Novel patient-centred approaches for survivorship, palliation and/or end-of-life care’  met at the European Commission to present and discuss their projects during a scientific meeting. Moreover, PREFERABLE has been discussed in detail together with the project-, legal- and financial EC-officers to set up the grant preparation. The second day was dedicated to H2020 project management. Beside PREFERABLE, the project FURTHER, led by Lenny Verkooijen, is also coordinated by the UMC Utrecht