N Engl J Med

ASCO 2025: Structured exercise improves disease-free survival in colon cancer survivors

June 11, 2025

Study details: The CHALLENGE trial was a phase 3, multicenter, randomized study enrolling 889 patients with resected stage II (high-risk) or III colon cancer who'd completed adjuvant chemotherapy. Participants were randomized to a 3-year structured exercise program or to health-education materials alone. The primary endpoint was disease-free survival (DFS), with overall survival (OS) as a key secondary endpoint. Median follow-up was 7.9 years.

Results: Structured exercise significantly improved DFS (hazard ratio [HR] for recurrence, new primary cancer, or death, 0.72; 95% confidence interval [CI], 0.55–0.94; P=0.02), with 5-year DFS rates of 80.3% in the exercise group vs. 73.9% in controls. OS was also improved (HR for death, 0.63; 95% CI, 0.43–0.94), with 8-year OS rates of 90.3% vs. 83.2%. Musculoskeletal adverse events were more frequent in the exercise group (18.5% vs. 11.5%)

Clinical impact: A long-term, structured exercise intervention after adjuvant chemotherapy confers significant DFS and OS benefits in colon cancer survivors. These findings support the integration of exercise into survivorship care.

Source:

Courneya KS, et al; CHALLENGE Investigators. (2025, Jun 1). N Engl J Med. Structured Exercise after Adjuvant Chemotherapy for Colon Cancer. https://pubmed.ncbi.nlm.nih.gov/40450658/