Grant title: EXERTION-mC: EXERcise during chemoTherapy infusION to improve outcomes for people with metastatic Colon cancer
Institution: University of Sydney
Grant awarded: September 2025
We know that exercise is important for people being treated for cancer for lots of reasons: it reduces fatigue, increases quality of life, benefits physical function and mental health, and also improves long-term survival after cancer treatment. Our study is going to test the idea that exercise could also make cancer treatments more effective. Our team has developed the use of intra-infusion exercise – cycling during a chemotherapy infusion – which we know is safe and feasible. We have found that this exercise will increase blood flow to tumours, so delivering more of the treatment drug to tumours as well, and we think it could mean that the treatment is more effective through this enhanced delivery.
We are incredibly grateful to Wereld Kanker Onderzoek Fonds and World Cancer Research Fund International for supporting our project which will allow us to measure the clinical outcomes (how much effect the treatment has on tumours) when we combine exercise with the infusion for the first time. If we are successful we might provide a way for people with cancer to improve their outcomes and revolutionise the way we use exercise as medicine. – Dr Kate Edwards
Background
Physical activity has significant benefits for people with cancer, including longer survival, fewer cancer recurrences, and lower cancer-specific mortality. Physical activity also reduces treatment-related side effects and helps maintain quality of life. However, most people with cancer do not get enough exercise during or after treatment.
This study explores a new approach to exercise for people with advanced colon cancer. Instead of sitting still during treatment, participants will use a stationary bike placed in front of their chemotherapy chair.
Our research suggests exercise during infusion is safe and may boost chemotherapy effectiveness by increasing blood flow, which could help deliver more of the drug to the tumour. Our early data shows that moderate-intensity exercise brings 158% more blood to tumours and may also reduce treatment side-effects. By targeting this time during treatment, we can deliver exercise in a safe, supervised way to encourage people to include exercise as part of their cancer care. This study will help us understand whether exercising during chemotherapy can improve outcomes for people with advanced colorectal cancer.
Aims and objectives
The EXERTION-mC study will test the effect of exercise during chemotherapy infusion for people with metastatic colorectal cancer. Specifically, we will examine if exercise can play a role in further reducing tumours during 6 months of chemotherapy. We will also evaluate whether exercise extends the time until the cancer progresses, reduces admissions to hospital or affects chemotherapy completion. The experience of side-effects, health-related quality of life, physical activity behaviour and body composition due to the exercise programme, will also be explored.
How it will be done
This study will use a randomised controlled trial design, meaning half of the people will exercise. The exercise group will cycle for 20 minutes during each chemotherapy infusion for 6 months. The usual care group will receive standard chemotherapy without exercise.
At the start of the study, all participants will meet with an exercise physiologist, who will provide general exercise advice and share information about exercise services available as part of routine care.
Potential impact
Exercise during infusion is a novel and time-efficient way to deliver exercise to people receiving chemotherapy for cancer. If it is shown to improve tumour response to chemotherapy, it could slow the spread of cancer and extend survival. This evidence would support advocacy for exercise to be offered as standard care during metastatic colorectal cancer treatment, making it more accessible to patients. In the future, we may explore whether exercise during chemotherapy could allow for lower drug doses while maintaining treatment effectiveness.