A review of physical activity in pancreatic ductal adenocarcinoma: Epidemiology, intervention, animal models, and clinical trials

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest types of cancer, and the increasing incidence of PDAC may be related to the prevalence of obesity. Physical activity (PA), a method known to mitigate obesity by increasing total energy expenditure, also modifies multiple cellular pathways associated with cancer hallmarks. Epidemiologic evidence has shown that PA can lower the risk of developing a variety of cancers, reduce some of the detrimental side effects of treatments, and improve patient's quality of life during cancer treatment. However, little is known about the pathways underlying the correlations observed between PA interventions and PDAC. Moreover, there is no standard dose of PA intervention that is ideal for PDAC prevention or as an adjuvant of cancer treatments. In this review, we summarize relevant literature showing how PDAC patients can benefit from PA, the potential of PA as an adjuvant treatment for PDAC, the studies using preclinical models of PDAC to study PA, and the clinical trials to date assessing the effects of PA in PDAC.

Keywords: Exercise; Pancreatic cancer; Pancreatic ductal adenocarcinoma; Physical activity; Translational research.

Conflict of interest statement

Conflict of interest/disclosures: None

Copyright © 2021 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Figures

Figure 1:

Overview of how PA affects pre-clinical and clinical models. Created with Biorender.com

Figure 2:

Summary of the common methods of pre-clinical PA assessment. Created with Biorender.com

Figure 3:

Summary of the clinical trials. (A) Times of intervention and (B) Types of exercise using in clinical trials. Created with Graphpad Prism 9