The ESMO Congress 2022, 9-13 September 2022. Parigi.

Background The main hypothesis on the positive effects of exercise in oncological patients has been focusing on lowering the basal systemic levels of cancer risk factors such as insulin-like growth factor-1 (IGF-1) and its binding proteins (IGFBP). However, there is a paucity of data and a remarkable heterogeneity when considering the response of the IGF-1 system to exercise in breast cancer survivors (BCS). In this study we tested the hypothesis that aerobic exercise training might normalize the IGF-1 system in BCS patients with normal to high level of IGF-1. Methods: Non physically active BCS women (n=30, age 52.7 ± 7.6 years), enrolled in the MoviS ‘Movement and Health Beyond Care’ study (clinicaltrial.gov identifier: NCT04818359), at high metabolic and hormonal risk of BC recurrences performed 3-month aerobic training (2 d/week of supervised and 1 d/week of unsupervised exercise) with increase of exercise intensity (40-70% HRR) and duration (20-60 min). Circulating IGF-1 and IGFBP3 levels were measured before and after the intervention. Results: VO2max increased by 10.1 % (mL·min-1·kg−1: before=30.7±5.7, after=33.4±6.8; p<0.001) while body mass index (kg/m2: before=26.0±5.0, after=25.5±4.7; p=0.035), glycemia (mg/dL: before=100.8±11.4, after=91.7±11.0; p<0.001) and insulin resistance (HOMA-IR score: before =2.07±1.54, after =1.53±1.11; p=0.005) decreased after training. Mean IGF-1 level did not change after training (ng/mL: before=164.3±70.9, after=166.8±57.6) while IGFBP3 level decreased (µg/mL: before=6.1±1.4, after=4.2±1.5). There was a negative correlation between pre-training IGF-1 levels and individual changes in IGF-1 after training (r=- 0.62, p<0.001). Accordingly, the IGF-1 coefficient of variation (CV) decreased after training (%: before=43.2, after=34.5). Finally, the correlation between IGF-1 and IGFBP3 levels was reduced after training (r: before=0.74, after 0.45, p<0.001). Conclusion: The exercise intervention modulates the IGF-1 system lowering the circulating IGF-1 variability, the IGFBP3 level and the relationship between IGF-1 and IGFBP3 among BCS patients.