Grant title: Long-term effects of exercise on quality of life in patients with metastatic breast cancer: a follow-up study of the randomised PREFERABLE-EFFECT study
Institution: University Medical Centre (UMC) Utrecht
Grant awarded: September 2025
In the PREFERABLE-EFFECT study, we investigated the effects of supervised exercise in patients with metastatic breast cancer. We found that a 9-month exercise intervention decreased the side-effects of the disease and its treatment, and improved the patients’ quality of life. I’m delighted to receive this grant from Wereld Kanker Onderzoek Fonds and World Cancer Research Fund International, as it allows us to recontact the participants of the PREFERABLE-EFFECT study to determine if the positive effects of exercise have been maintained – Prof Anne May
Background
Breast cancer is the most common cancer worldwide. Metastatic breast cancer is the main cause of breast cancer-related deaths. While survival rates have improved due to better and more treatment options, quality of life remains a significant concern for patients with metastatic breast cancer. Therefore, maintaining or even improving quality of life is very important during this stage of their disease. The PREFERABLE-EFFECT study, which is a large international project, included 357 patients with metastatic breast cancer and showed that a 9-month supervised exercise programme reduced fatigue and improved clinically important outcomes such as pain and shortness of breath, leading to a better quality of life. The programme was designed to encourage patients to continue exercising independently after the study, promoting long-term benefits from exercise.
There is no evidence on whether patients can maintain physical activity levels and that improvements last, particularly in patients with metastatic breast cancer. This project aims to address this gap by examining whether the benefits of exercise persist over time. Furthermore, we aim to evaluate cost-effectiveness (i.e., better quality of life and lower costs) of the exercise programme in the long term.
Aims and objectives
The main goal of this project is to investigate the long-term effects of the PREFERABLE-EFFECT exercise programme on quality of life in patients with metastatic breast cancer. We expect that patients will continue experiencing positive effects even after the study has ended. As a secondary goal, we will examine whether and how patients maintained a physically active lifestyle. Additionally, we will evaluate exercise effects on fatigue, pain and shortness of breath in the long term, as well as the long-term cost-effectiveness of the exercise programme.
How it will be done
We will contact participants of the PREFERABLE-EFFECT randomised controlled trial 2–3 years after they’ve finished the study. PREFERABLE-EFFECT was conducted in 5 European countries and Australia between 2020 and 2022. This study investigated the effects of exercise on fatigue and quality of life in patients with metastatic breast cancer. In total, 357 patients with metastatic breast cancer took part, with half participating in the exercise programme and half serving as a control group.
For this follow-up study, patients who are still alive (expected to be 35–50%) will be invited to participate. These participants will complete questionnaires at home, measuring outcomes comparable to those in the initial EFFECT study. A structured interview will be conducted to evaluate physical activity levels after study participation and participants will be asked to wear an activity tracker for 1 week. Statistical analyses will be performed to investigate whether the benefits of the exercise programme were maintained after 2–3 years.
Potential impact
This project has the potential to provide important insights into the long-term effects of exercise for patients with metastatic breast cancer and to boost the integration of exercise into the standard care for metastatic breast cancer, particularly since this aligns with the primary goal of these patients: to maintain or improve their quality of life. By understanding how long the benefits of exercise last and determining long-term cost-effectiveness, this study could help shape future cancer care strategies. In this, we collaborate with a study-specific Patient Advisory Group and The European Breast Cancer Coalition Europa Donna.