Association between physical activity and neoadjuvant chemotherapy completion and pathologic complete response in primary breast cancer: the canto study

Association between physical activity and neoadjuvant chemotherapy completion and pathologic complete response in primary breast cancer: the canto study

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ABSTRACT BACKGROUND Regular physical activity is associated with improved symptom control in patients with breast cancer but its association with chemotherapy completion or response is unclear. METHODS Using a prospective design, 1075 breast cancer patients receiving neoadjuvant chemotherapy between March 2012 and February 2017 were studied. Physical activity was assessed using the Global Physical Activity Questionnaire [GPAQ-16], quantified in standardised MET-h/wk. Chemotherapy completion was defined as the proportion of patients completing planned treatment course, requiring dose reduction, or requiring dose delay. Response was evaluated by pathologic complete response (pCR). Associations between physical activity and primary outcomes were assessed using multivariable logistic regression models. RESULTS There was no differences between any chemotherapy completion outcome on the basis of physical activity classification. The percent of patients not completing planned treatment was 5.7% for ≦0.33 MET-h/wk, compared with 6.8% for 0.34–16.65 MET-h/wk, and 4.6% for ≥16.6 MET-h/wk (_p_ = 0.52). No significant relationships were observed between physical activity dose classification and pCR for the overall cohort or upon stratification by clinical subtype. CONCLUSION Future studies are required to further investigate the relationship between pre-treatment levels of physical activity and function on treatment completion and response in breast and other cancer populations. CLINICAL TRIAL REGISTRATION NCT01993498. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 24 print issues and online access $259.00 per year only $10.79 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS ANALYSIS OF THE STORM COHORT REVEALS PHYSICAL ACTIVITY TO BE ASSOCIATED WITH SURVIVAL IN METASTATIC BREAST CANCER Article Open access 01 July 2020 PHYSICAL DETERIORATION AND ADAPTIVE RECOVERY IN PHYSICALLY INACTIVE BREAST CANCER PATIENTS DURING ADJUVANT CHEMOTHERAPY: A RANDOMISED CONTROLLED TRIAL Article Open access 16 June 2020 ETHNIC AND BIOLOGICAL DIFFERENCES IN THE ASSOCIATION BETWEEN PHYSICAL ACTIVITY AND SURVIVAL AFTER BREAST CANCER Article Open access 09 October 2020 DATA AVAILABILITY Data will be made available upon reasonable request. REFERENCES * Budman DR, Berry DA, Cirrincione CT, Henderson IC, Wood WC, Weiss RB, et al. Dose and dose intensity as determinants of outcome in the adjuvant treatment of breast cancer. The Cancer and Leukemia Group B. J Natl Cancer Inst. 1998;90:1205–11. Article  CAS  Google Scholar  * Yuan JQ, Wang SM, Tang LL, Mao J, Wu YH, Hai J, et al. Relative dose intensity and therapy efficacy in different breast cancer molecular subtypes: a retrospective study of early stage breast cancer patients treated with neoadjuvant chemotherapy. Breast Cancer Res Treat. 2015;151:405–13. Article  CAS  Google Scholar  * Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C. Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up. N Engl J Med. 1995;332:901–6. Article  CAS  Google Scholar  * Lyman GH, Dale DC, Crawford J. Incidence and predictors of low dose-intensity in adjuvant breast cancer chemotherapy: a nationwide study of community practices. J Clin Oncol. 2003;21:4524–31. Article  Google Scholar  * Bland KA, Zadravec K, Landry T, Weller S, Meyers L, Campbell KL. Impact of exercise on chemotherapy completion rate: a systematic review of the evidence and recommendations for future exercise oncology research. Crit Rev Oncol Hematol. 2019;136:79–85. Article  Google Scholar  * Groen WG, Naaktgeboren WR, van Harten WH, van Vulpen JK, Kool N, Sonke GS, et al. Physical fitness and chemotherapy tolerance in patients with early-stage breast cancer. Med Sci Sports Exerc. 2021;54:537–42. * An KY, Arthuso FZ, Kang DW, Morielli AR, Ntoukas SM, Friedenreich CM, et al. Exercise and health-related fitness predictors of chemotherapy completion in breast cancer patients: pooled analysis of two multicenter trials. Breast Cancer Res Treat. 2021;188:399–407. Article  CAS  Google Scholar  * Scott JM, Stene G, Edvardsen E, Jones LW. Performance status in cancer: not broken, but time for an upgrade? J Clin Oncol. 2020;38:2824–9. Article  Google Scholar  * Kokkinos P, Myers J. Exercise and physical activity: clinical outcomes and applications. Circulation. 2010;122:1637–48. Article  Google Scholar  * Koelwyn GJ, Khouri M, Mackey JR, Douglas PS, Jones LW. Running on empty: cardiovascular reserve capacity and late effects of therapy in cancer survivorship. J Clin Oncol. 2012;30:4458–61. Article  Google Scholar  * Betof AS, Lascola CD, Weitzel D, Landon C, Scarbrough PM, Devi GR, et al. Modulation of murine breast tumor vascularity, hypoxia and chemotherapeutic response by exercise. J Natl Cancer Inst. 2015;107:djv040. * Vaz-Luis I, Cottu P, Mesleard C, Martin AL, Dumas A, Dauchy S, et al. UNICANCER: French prospective cohort study of treatment-related chronic toxicity in women with localised breast cancer (CANTO). ESMO Open. 2019;4:e000562. Article  Google Scholar  * WHO. WHO STEPS Surveillance Manual: the WHO STEPwise approach to chronic disease risk factor surveillance. Geneva: Wrold Health Organization; 2005. * WHO. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010. * Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6:790–804. Article  Google Scholar  * von Minckwitz G, Untch M, Blohmer JU, Costa SD, Eidtmann H, Fasching PA, et al. Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. J Clin Oncol. 2012;30:1796–804. Article  Google Scholar  * Usiskin I, Li F, Irwin ML, Cartmel B, Sanft T. Association between pre-diagnosis BMI, physical activity, pathologic complete response, and chemotherapy completion in women treated with neoadjuvant chemotherapy for breast cancer. Breast Cancer. 2019;26:719–28. Article  Google Scholar  * Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396–404. Article  Google Scholar  * van Waart H, Stuiver MM, van Harten WH, Geleijn E, Kieffer JM, Buffart LM, et al. Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of the PACES randomized clinical trial. J Clin Oncol. 2015;33:1918–27. Article  Google Scholar  * Van Blarigan EL, Gerstenberger JP, Kenfield SA, Giovannucci EL, Stampfer MJ, Jones LW, et al. Physical activity and prostate tumor vessel morphology: data from the health professionals follow-up study. Cancer Prev Res (Philos). 2015;8:962–7. Article  Google Scholar  * Nia HT, Munn LL, Jain RK. Physical traits of cancer. Science. 2020;370:eaaz0868. * Yang L, Morielli AR, Heer E, Kirkham AA, Cheung WY, Usmani N, et al. Effects of exercise on cancer treatment efficacy: a systematic review of preclinical and clinical studies. Cancer Res. 2021;81:4889–95. Article  CAS  Google Scholar  * Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical activity and mortality in cancer survivors: a systematic review and meta-analysis. JNCI Cancer Spectr. 2020;4:pkz080. Article  Google Scholar  * Wennerberg E, Lhuillier C, Rybstein MD, Dannenberg K, Rudqvist NP, Koelwyn GJ, et al. Exercise reduces immune suppression and breast cancer progression in a preclinical model. Oncotarget. 2020;11:452–61. Article  Google Scholar  * Koelwyn GJ, Quail DF, Zhang X, White RM, Jones LW. Exercise-dependent regulation of the tumour microenvironment. Nat Rev Cancer. 2017;17:620–32. Article  Google Scholar  Download references ACKNOWLEDGEMENTS An interim analysis from this study was presented at the San Antonio Breast Cancer Symposium 2018, Dec 4–8, San Antonio, TX. FUNDING CANTO is funded by Agence Nationale de la Recherche (ANR-10-COHO-0004). IV-L received support from Odyssea, Foundation Gustave Roussy, and CCR17483507 Career Catalyst Research grant. ADM received support from Susan G. Komen, Clinical Research Fellowship from ESMO. LWJ is supported in part by funding from the National Cancer Institute, AKTIV Against Cancer, the KavliTrust, and the Memorial Sloan Kettering Cancer Center Support Grant/Core Grant (P30 CA008748). AUTHOR INFORMATION Author notes * These authors contributed equally: Ines Vaz-Luis, Lee W Jones. AUTHORS AND AFFILIATIONS * University of California Los Angeles, Los Angeles, CA, USA Jennifer L. Baker * INSERM U 981 - Prédicteurs moléculaires et nouvelles cibles en oncologie, Institut Gustave Roussy, Villejuif, France Antonio Di Meglio, Arnauld S. Gbenou, Mayssam El Mouhebb, Andre Fabrice & Ines Vaz-Luis * Memorial Sloan Kettering Cancer Center, New York City, NY, USA Neil M. Iyengar & Lee W. Jones * Weill Cornell Medical College, New York, NY, USA Neil M. Iyengar & Lee W. Jones * INSERM U1018 CESP, Service de Biostatistique et d’Epidemiologie, Institut Gustave Roussy, Villejuif, France Stefan Michiels * Institut Curie, Paris, France Paul Cottu * Institut Curie Saint Cloud, Saint Cloud, France Florence Lerebours & Patrick Arveux * Centre Georges-Francois Leclerc, Dijon, France Charles Coutant * Insitut de cancerlogie de Lorraine, Nancy, France Anne Lesur * Centre Leon Berard, Lyon, France Oliver Tredan * Centre Oscar Lambret, Lille, France Laurence Vanlemmens * Institut de Cancérologie Jean Godinot, Reims, France Christelle Jouannaud * Centre François Baclesse, Caen, France Iona Hrab * UNICANCER, Paris, France Sibille Everhard & Anne-Laure Martin * Medical Oncology Department, Institut Gustave Roussy, Villejuif, France Andre Fabrice & Ines Vaz-Luis Authors * Jennifer L. Baker View author publications You can also search for this author inPubMed Google Scholar * Antonio Di Meglio View author publications You can also search for this author inPubMed Google Scholar * Arnauld S. Gbenou View author publications You can also search for this author inPubMed Google Scholar * Mayssam El Mouhebb View author publications You can also search for this author inPubMed Google Scholar * Neil M. Iyengar View author publications You can also search for this author inPubMed Google Scholar * Stefan Michiels View author publications You can also search for this author inPubMed Google Scholar * Paul Cottu View author publications You can also search for this author inPubMed Google Scholar * Florence Lerebours View author publications You can also search for this author inPubMed Google Scholar * Charles Coutant View author publications You can also search for this author inPubMed Google Scholar * Anne Lesur View author publications You can also search for this author inPubMed Google Scholar * Oliver Tredan View author publications You can also search for this author inPubMed Google Scholar * Laurence Vanlemmens View author publications You can also search for this author inPubMed Google Scholar * Christelle Jouannaud View author publications You can also search for this author inPubMed Google Scholar * Iona Hrab View author publications You can also search for this author inPubMed Google Scholar * Sibille Everhard View author publications You can also search for this author inPubMed Google Scholar * Anne-Laure Martin View author publications You can also search for this author inPubMed Google Scholar * Patrick Arveux View author publications You can also search for this author inPubMed Google Scholar * Andre Fabrice View author publications You can also search for this author inPubMed Google Scholar * Ines Vaz-Luis View author publications You can also search for this author inPubMed Google Scholar * Lee W. Jones View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS JLB: Wrote the paper. ADM, ASG, MEM: Conceived and designed the analysis and performed the analysis. NMI: Conceived and designed the analysis. SM, PC, FL, CC, AL, OT, LV, CJ, IH, SE, A-LM, PA, AF: Collected the data. IV-L, LWJ: Conceived and designed the analysis and wrote the paper. CORRESPONDING AUTHORS Correspondence to Ines Vaz-Luis or Lee W. Jones. ETHICS DECLARATIONS COMPETING INTERESTS LWJ owns stock in Pacylex, Inc. and Illumisonics, Inc. IV-L reports personal fees from AstraZeneca, Kephren, Amgen, and Novartis. ADM reports personal fees from Thermo Fisher and grants from European Society for Medical Oncology (ESMO), fellowship support, outside the submitted work. ETHICS APPROVAL AND CONSENT TO PARTICIPATE Informed consent was obtained from all patients prior to study participation at each institution. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Baker, J.L., Di Meglio, A., Gbenou, A.S. _et al._ Association between physical activity and neoadjuvant chemotherapy completion and pathologic complete response in primary breast cancer: the CANTO study. _Br J Cancer_ 127, 886–891 (2022). https://doi.org/10.1038/s41416-022-01870-y Download citation * Received: 27 August 2020 * Revised: 28 April 2022 * Accepted: 25 May 2022 * Published: 17 June 2022 * Issue Date: 01 September 2022 * DOI: https://doi.org/10.1038/s41416-022-01870-y SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative

ABSTRACT BACKGROUND Regular physical activity is associated with improved symptom control in patients with breast cancer but its association with chemotherapy completion or response is


unclear. METHODS Using a prospective design, 1075 breast cancer patients receiving neoadjuvant chemotherapy between March 2012 and February 2017 were studied. Physical activity was assessed


using the Global Physical Activity Questionnaire [GPAQ-16], quantified in standardised MET-h/wk. Chemotherapy completion was defined as the proportion of patients completing planned


treatment course, requiring dose reduction, or requiring dose delay. Response was evaluated by pathologic complete response (pCR). Associations between physical activity and primary outcomes


were assessed using multivariable logistic regression models. RESULTS There was no differences between any chemotherapy completion outcome on the basis of physical activity classification.


The percent of patients not completing planned treatment was 5.7% for ≦0.33 MET-h/wk, compared with 6.8% for 0.34–16.65 MET-h/wk, and 4.6% for ≥16.6 MET-h/wk (_p_ = 0.52). No significant


relationships were observed between physical activity dose classification and pCR for the overall cohort or upon stratification by clinical subtype. CONCLUSION Future studies are required to


further investigate the relationship between pre-treatment levels of physical activity and function on treatment completion and response in breast and other cancer populations. CLINICAL


TRIAL REGISTRATION NCT01993498. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your


institution Subscribe to this journal Receive 24 print issues and online access $259.00 per year only $10.79 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access


to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read


our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS ANALYSIS OF THE STORM COHORT REVEALS PHYSICAL ACTIVITY TO BE ASSOCIATED WITH SURVIVAL IN METASTATIC BREAST CANCER


Article Open access 01 July 2020 PHYSICAL DETERIORATION AND ADAPTIVE RECOVERY IN PHYSICALLY INACTIVE BREAST CANCER PATIENTS DURING ADJUVANT CHEMOTHERAPY: A RANDOMISED CONTROLLED TRIAL


Article Open access 16 June 2020 ETHNIC AND BIOLOGICAL DIFFERENCES IN THE ASSOCIATION BETWEEN PHYSICAL ACTIVITY AND SURVIVAL AFTER BREAST CANCER Article Open access 09 October 2020 DATA


AVAILABILITY Data will be made available upon reasonable request. REFERENCES * Budman DR, Berry DA, Cirrincione CT, Henderson IC, Wood WC, Weiss RB, et al. Dose and dose intensity as


determinants of outcome in the adjuvant treatment of breast cancer. The Cancer and Leukemia Group B. J Natl Cancer Inst. 1998;90:1205–11. Article  CAS  Google Scholar  * Yuan JQ, Wang SM,


Tang LL, Mao J, Wu YH, Hai J, et al. Relative dose intensity and therapy efficacy in different breast cancer molecular subtypes: a retrospective study of early stage breast cancer patients


treated with neoadjuvant chemotherapy. Breast Cancer Res Treat. 2015;151:405–13. Article  CAS  Google Scholar  * Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C. Adjuvant


cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up. N Engl J Med. 1995;332:901–6. Article  CAS  Google Scholar  * Lyman GH,


Dale DC, Crawford J. Incidence and predictors of low dose-intensity in adjuvant breast cancer chemotherapy: a nationwide study of community practices. J Clin Oncol. 2003;21:4524–31. Article


  Google Scholar  * Bland KA, Zadravec K, Landry T, Weller S, Meyers L, Campbell KL. Impact of exercise on chemotherapy completion rate: a systematic review of the evidence and


recommendations for future exercise oncology research. Crit Rev Oncol Hematol. 2019;136:79–85. Article  Google Scholar  * Groen WG, Naaktgeboren WR, van Harten WH, van Vulpen JK, Kool N,


Sonke GS, et al. Physical fitness and chemotherapy tolerance in patients with early-stage breast cancer. Med Sci Sports Exerc. 2021;54:537–42. * An KY, Arthuso FZ, Kang DW, Morielli AR,


Ntoukas SM, Friedenreich CM, et al. Exercise and health-related fitness predictors of chemotherapy completion in breast cancer patients: pooled analysis of two multicenter trials. Breast


Cancer Res Treat. 2021;188:399–407. Article  CAS  Google Scholar  * Scott JM, Stene G, Edvardsen E, Jones LW. Performance status in cancer: not broken, but time for an upgrade? J Clin Oncol.


2020;38:2824–9. Article  Google Scholar  * Kokkinos P, Myers J. Exercise and physical activity: clinical outcomes and applications. Circulation. 2010;122:1637–48. Article  Google Scholar  *


Koelwyn GJ, Khouri M, Mackey JR, Douglas PS, Jones LW. Running on empty: cardiovascular reserve capacity and late effects of therapy in cancer survivorship. J Clin Oncol. 2012;30:4458–61.


Article  Google Scholar  * Betof AS, Lascola CD, Weitzel D, Landon C, Scarbrough PM, Devi GR, et al. Modulation of murine breast tumor vascularity, hypoxia and chemotherapeutic response by


exercise. J Natl Cancer Inst. 2015;107:djv040. * Vaz-Luis I, Cottu P, Mesleard C, Martin AL, Dumas A, Dauchy S, et al. UNICANCER: French prospective cohort study of treatment-related chronic


toxicity in women with localised breast cancer (CANTO). ESMO Open. 2019;4:e000562. Article  Google Scholar  * WHO. WHO STEPS Surveillance Manual: the WHO STEPwise approach to chronic


disease risk factor surveillance. Geneva: Wrold Health Organization; 2005. * WHO. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010. * Bull FC,


Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6:790–804. Article  Google Scholar  * von


Minckwitz G, Untch M, Blohmer JU, Costa SD, Eidtmann H, Fasching PA, et al. Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various


intrinsic breast cancer subtypes. J Clin Oncol. 2012;30:1796–804. Article  Google Scholar  * Usiskin I, Li F, Irwin ML, Cartmel B, Sanft T. Association between pre-diagnosis BMI, physical


activity, pathologic complete response, and chemotherapy completion in women treated with neoadjuvant chemotherapy for breast cancer. Breast Cancer. 2019;26:719–28. Article  Google Scholar 


* Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a


multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396–404. Article  Google Scholar  * van Waart H, Stuiver MM, van Harten WH, Geleijn E, Kieffer JM, Buffart LM, et al. Effect


of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of


the PACES randomized clinical trial. J Clin Oncol. 2015;33:1918–27. Article  Google Scholar  * Van Blarigan EL, Gerstenberger JP, Kenfield SA, Giovannucci EL, Stampfer MJ, Jones LW, et al.


Physical activity and prostate tumor vessel morphology: data from the health professionals follow-up study. Cancer Prev Res (Philos). 2015;8:962–7. Article  Google Scholar  * Nia HT, Munn


LL, Jain RK. Physical traits of cancer. Science. 2020;370:eaaz0868. * Yang L, Morielli AR, Heer E, Kirkham AA, Cheung WY, Usmani N, et al. Effects of exercise on cancer treatment efficacy: a


systematic review of preclinical and clinical studies. Cancer Res. 2021;81:4889–95. Article  CAS  Google Scholar  * Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical activity and


mortality in cancer survivors: a systematic review and meta-analysis. JNCI Cancer Spectr. 2020;4:pkz080. Article  Google Scholar  * Wennerberg E, Lhuillier C, Rybstein MD, Dannenberg K,


Rudqvist NP, Koelwyn GJ, et al. Exercise reduces immune suppression and breast cancer progression in a preclinical model. Oncotarget. 2020;11:452–61. Article  Google Scholar  * Koelwyn GJ,


Quail DF, Zhang X, White RM, Jones LW. Exercise-dependent regulation of the tumour microenvironment. Nat Rev Cancer. 2017;17:620–32. Article  Google Scholar  Download references


ACKNOWLEDGEMENTS An interim analysis from this study was presented at the San Antonio Breast Cancer Symposium 2018, Dec 4–8, San Antonio, TX. FUNDING CANTO is funded by Agence Nationale de


la Recherche (ANR-10-COHO-0004). IV-L received support from Odyssea, Foundation Gustave Roussy, and CCR17483507 Career Catalyst Research grant. ADM received support from Susan G. Komen,


Clinical Research Fellowship from ESMO. LWJ is supported in part by funding from the National Cancer Institute, AKTIV Against Cancer, the KavliTrust, and the Memorial Sloan Kettering Cancer


Center Support Grant/Core Grant (P30 CA008748). AUTHOR INFORMATION Author notes * These authors contributed equally: Ines Vaz-Luis, Lee W Jones. AUTHORS AND AFFILIATIONS * University of


California Los Angeles, Los Angeles, CA, USA Jennifer L. Baker * INSERM U 981 - Prédicteurs moléculaires et nouvelles cibles en oncologie, Institut Gustave Roussy, Villejuif, France Antonio


Di Meglio, Arnauld S. Gbenou, Mayssam El Mouhebb, Andre Fabrice & Ines Vaz-Luis * Memorial Sloan Kettering Cancer Center, New York City, NY, USA Neil M. Iyengar & Lee W. Jones *


Weill Cornell Medical College, New York, NY, USA Neil M. Iyengar & Lee W. Jones * INSERM U1018 CESP, Service de Biostatistique et d’Epidemiologie, Institut Gustave Roussy, Villejuif,


France Stefan Michiels * Institut Curie, Paris, France Paul Cottu * Institut Curie Saint Cloud, Saint Cloud, France Florence Lerebours & Patrick Arveux * Centre Georges-Francois Leclerc,


Dijon, France Charles Coutant * Insitut de cancerlogie de Lorraine, Nancy, France Anne Lesur * Centre Leon Berard, Lyon, France Oliver Tredan * Centre Oscar Lambret, Lille, France Laurence


Vanlemmens * Institut de Cancérologie Jean Godinot, Reims, France Christelle Jouannaud * Centre François Baclesse, Caen, France Iona Hrab * UNICANCER, Paris, France Sibille Everhard & 


Anne-Laure Martin * Medical Oncology Department, Institut Gustave Roussy, Villejuif, France Andre Fabrice & Ines Vaz-Luis Authors * Jennifer L. Baker View author publications You can


also search for this author inPubMed Google Scholar * Antonio Di Meglio View author publications You can also search for this author inPubMed Google Scholar * Arnauld S. Gbenou View author


publications You can also search for this author inPubMed Google Scholar * Mayssam El Mouhebb View author publications You can also search for this author inPubMed Google Scholar * Neil M.


Iyengar View author publications You can also search for this author inPubMed Google Scholar * Stefan Michiels View author publications You can also search for this author inPubMed Google


Scholar * Paul Cottu View author publications You can also search for this author inPubMed Google Scholar * Florence Lerebours View author publications You can also search for this author


inPubMed Google Scholar * Charles Coutant View author publications You can also search for this author inPubMed Google Scholar * Anne Lesur View author publications You can also search for


this author inPubMed Google Scholar * Oliver Tredan View author publications You can also search for this author inPubMed Google Scholar * Laurence Vanlemmens View author publications You


can also search for this author inPubMed Google Scholar * Christelle Jouannaud View author publications You can also search for this author inPubMed Google Scholar * Iona Hrab View author


publications You can also search for this author inPubMed Google Scholar * Sibille Everhard View author publications You can also search for this author inPubMed Google Scholar * Anne-Laure


Martin View author publications You can also search for this author inPubMed Google Scholar * Patrick Arveux View author publications You can also search for this author inPubMed Google


Scholar * Andre Fabrice View author publications You can also search for this author inPubMed Google Scholar * Ines Vaz-Luis View author publications You can also search for this author


inPubMed Google Scholar * Lee W. Jones View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS JLB: Wrote the paper. ADM, ASG, MEM: Conceived and


designed the analysis and performed the analysis. NMI: Conceived and designed the analysis. SM, PC, FL, CC, AL, OT, LV, CJ, IH, SE, A-LM, PA, AF: Collected the data. IV-L, LWJ: Conceived and


designed the analysis and wrote the paper. CORRESPONDING AUTHORS Correspondence to Ines Vaz-Luis or Lee W. Jones. ETHICS DECLARATIONS COMPETING INTERESTS LWJ owns stock in Pacylex, Inc. and


Illumisonics, Inc. IV-L reports personal fees from AstraZeneca, Kephren, Amgen, and Novartis. ADM reports personal fees from Thermo Fisher and grants from European Society for Medical


Oncology (ESMO), fellowship support, outside the submitted work. ETHICS APPROVAL AND CONSENT TO PARTICIPATE Informed consent was obtained from all patients prior to study participation at


each institution. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. RIGHTS AND


PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Baker, J.L., Di Meglio, A., Gbenou, A.S. _et al._ Association between physical activity and neoadjuvant chemotherapy


completion and pathologic complete response in primary breast cancer: the CANTO study. _Br J Cancer_ 127, 886–891 (2022). https://doi.org/10.1038/s41416-022-01870-y Download citation *


Received: 27 August 2020 * Revised: 28 April 2022 * Accepted: 25 May 2022 * Published: 17 June 2022 * Issue Date: 01 September 2022 * DOI: https://doi.org/10.1038/s41416-022-01870-y SHARE


THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to


clipboard Provided by the Springer Nature SharedIt content-sharing initiative