Physical activity and checkpoint inhibition: association with toxicity and survival in a prospective trial

While animal experiments suggest beneficial effects of physical activity (PA) on anti-tumor immunity, little is known about the effects of PA on immune checkpoint inhibitor (ICI) toxicity and efficacy in humans. Analysis in the cohort of the prospective UNICIT trial (‘unraveling immune checkpoint inhibitor induced toxicity’; n=251; median follow-up 20 months) at University of Utrecht Medical Center (The Netherlands) investigated the association of baseline PA with immune-related adverse events (irAEs) and survival in patients receiving ICIs. Moderate (aOR 0.34; 95% CI 0.12-0.90) and high (0.19; 0.05-0.55) levels of total PA were associated with lower odds of severe irAEs compared with low levels of total PA. Moderate (aHR 0.58; 95% CI 0.32-1.04) and high (0.48; 0.27-0.89) levels of total PS were also associated with prolonged survival. The authors conclude that higher PA levels at the start of ICI treatment were associated with lower risk of severe irAEs and probably longer survival.