A groundbreaking new clinical trial is set to explore the therapeutic potential of resistance exercise in combating sarcopenia among breast cancer patients undergoing neoadjuvant chemotherapy. Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, is a common and debilitating syndrome frequently observed in cancer patients. Its prevalence in this population poses profound challenges, including increased treatment toxicity, postoperative complications, and diminished overall survival. Despite growing evidence that resistance training can reliably counteract muscle loss in various settings, its application specifically as a prehabilitation tool during chemotherapy remains insufficiently studied.
This novel randomized controlled trial (RCT) aims to fill this critical knowledge gap by systematically investigating the effects of a supervised resistance exercise intervention on sarcopenia progression and related clinical outcomes in women undergoing neoadjuvant chemotherapy for breast cancer. Targeting a cohort of 46 female patients aged 20 and older, the study is uniquely positioned to unravel the complexities of muscle preservation within the context of aggressive cancer treatment modalities. Executed under robust methodological standards, this trial promises to enhance therapeutic strategies significantly, ultimately improving patients’ quality of life and treatment tolerance.
The rationale underpinning the trial is deeply rooted in the multifactorial impact of sarcopenia on cancer management. Patients exhibiting significant muscle wasting are known to experience increased susceptibility to chemotherapy-induced toxicities, prolonged hospitalization, and reduced functional independence. Furthermore, existing literature highlights that sarcopenia can aggravate cancer-related symptoms such as fatigue, pain, and diminished physical performance, which cumulatively impair psychological and social well-being. As such, interventions targeting sarcopenia are not merely supportive but integral to comprehensive oncological care pathways.
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By implementing a hybrid, expert-supervised resistance exercise regimen, the research team addresses a critical barrier to intervention feasibility—patient accessibility. Recognizing that physical debilitation, treatment side effects, and geographic constraints often limit consistent participation, the program offers both on-site and virtual training sessions. Each participant will engage in three 60-minute resistance exercise sessions per week, empowering patients with flexibility while ensuring adherence to rigorous exercise protocols. This innovative delivery model is anticipated to foster higher retention rates and robust data collection.
Alongside tracking changes in muscle mass, the trial will employ a battery of validated assessments, measuring muscle strength and physical performance as core indicators of sarcopenia reversal or stabilization. These objective physiological markers are complemented by self-reported evaluations of cancer-related symptoms and overall quality of life. The multidimensional outcome framework underscores the study’s commitment to capturing the comprehensive impact of resistance exercise, encompassing not only physical but also psychosocial dimensions of patient health.
Importantly, this investigation integrates a longitudinal design with multiple assessment timepoints—baseline, mid-intervention at six and twelve weeks, and upon program completion at eighteen weeks. Such granularity allows for dynamic tracking of intervention effects and the identification of critical windows during chemotherapy when resistance training may yield maximal benefit. The resulting data will inform optimal exercise prescription parameters tailored to the breast cancer neoadjuvant setting.
This RCT is situated within the institutional support of Yonsei University Health System’s Severance Hospital, adhering to stringent ethical standards under institutional review board approval. The prospective registration of the trial (Clinical Research Information Service, reference KCT0008961) further emphasizes transparency and scientific rigor, facilitating replication and inclusion in future meta-analyses.
Beyond direct clinical outcomes, the study has broader implications for oncology rehabilitation frameworks. The integration of prehabilitation exercise protocols into standard cancer care pathways demands evidence-based validation, particularly for vulnerable populations experiencing sarcopenia. Positive findings from this examination could serve as a catalyst for widespread implementation of resistance training as a non-pharmacological adjunct, potentially transforming supportive care paradigms and enhancing survivorship trajectories.
Current gaps in existing research often stem from heterogeneous study designs, small sample sizes, or retrospective analyses limiting causal inference. This trial’s randomized controlled design and hybrid delivery model mark a significant advance, providing high-quality evidence that is both internally valid and pragmatically feasible for real-world application. Addressing the challenge of neoadjuvant chemotherapy-associated sarcopenia with a multidisciplinary, exercise oncology approach resonates with contemporary calls for integrative cancer care.
Moreover, the focus on breast cancer, a disease with high global incidence and substantial survivorship populations, underscores the study’s public health relevance. Muscle preservation strategies that mitigate chemotherapy side effects could decrease healthcare utilization, reduce treatment interruptions, and improve long-term functional independence, all of which impart meaningful cost-effectiveness benefits.
Emerging mechanistic research also supports the biological plausibility of exercise-mediated sarcopenia mitigation. Resistance training is known to stimulate muscle protein synthesis via activation of mTOR pathways, enhance mitochondrial function, and reduce systemic inflammation—processes often dysregulated in cancer cachexia and treatment-induced muscle atrophy. This trial’s outcomes may provide clinical corroboration of these molecular insights in a cancer-specific cohort.
In conclusion, this pioneering RCT holds promise to reshape how oncologists and rehabilitation specialists approach musculoskeletal health in breast cancer patients receiving neoadjuvant chemotherapy. By rigorously examining resistance exercise as a prehabilitative strategy, the study aims to develop actionable, evidence-based interventions that integrate seamlessly into multidisciplinary cancer treatment plans. The anticipated results will not only clarify the role of exercise in sarcopenia management but also inspire future research into personalized, holistic cancer care.
As the oncology community continues to prioritize survivorship and quality of life, such innovative trials are indispensable in guiding clinical practice evolution. This research embodies the confluence of exercise science, oncology, and patient-centered care, marking an exciting frontier in supportive cancer therapies. The scientific and medical worlds eagerly await the insights this trial will yield, potentially heralding a new standard of care wherein resistance training becomes a routine, indispensable component of breast cancer treatment.
With enrollment commencing shortly and follow-up assessments meticulously planned, this study represents a beacon of hope for patients, clinicians, and researchers alike. Its outcomes could materially shift our understanding of how targeted physical interventions can modulate cancer treatment trajectories, enhancing resilience and wellbeing amidst the challenges of neoadjuvant chemotherapy. Ultimately, this endeavor epitomizes the spirit of translational medicine—turning laboratory and physiological knowledge into impactful clinical interventions that improve lives.
Subject of Research: Effects of resistance exercise intervention on sarcopenia in patients undergoing neoadjuvant chemotherapy for breast cancer.
Article Title: Evaluating the effects of a resistance exercise intervention for sarcopenia in patients receiving neoadjuvant chemotherapy for breast cancer: study protocol for a randomized controlled trial
Article References:
Jang, M.K., Park, S., Jeon, J.Y. et al. Evaluating the effects of a resistance exercise intervention for sarcopenia in patients receiving neoadjuvant chemotherapy for breast cancer: study protocol for a randomized controlled trial. BMC Cancer 25, 1296 (2025). https://doi.org/10.1186/s12885-025-14721-9
Image Credits: Scienmag.com
DOI: https://doi.org/10.1186/s12885-025-14721-9
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