Phase 2 trial of exercise and low-dose ibuprofen for cancer-related cognitive impairment in patients receiving chemotherapy
Mené sur 86 patients atteints d'un cancer (âge moyen : 53,6 ans), cet essai de phase II évalue l'effet, sur leurs déficiences cognitives induites par la chimiothérapie, d'exercices physiques à domicile avec ou sans faibles doses d'ibuprofène
Background: Interventions for cancer-related cognitive impairment are understudied, particularly during therapy.
Methods: Patients with cancer receiving chemotherapy reporting cognitive problems were randomized to one of four study arms for 6 weeks in this phase 2 randomized controlled trial with a 2 × 2 factorial design. Study arms included: Exercise for Cancer Patients©® (EXCAP)–ibuprofen, EXCAP–placebo, ibuprofen only, and placebo only. EXCAP is a home-based, low to moderate-intensity, progressive walking and resistance exercise prescription. Cognitive and biologic assessments were conducted at baseline and post-intervention.
Results: Eighty-six participants were randomized (mean age, 53.60; 88.37% female). Between-group analyses showed that participants in the EXCAP–placebo group demonstrated significantly better attention performance on the Trail Making Test compared to the placebo group (−21.57 seconds, p < .001; Cohen’s d = –1.31; 95% CI, –2.18 to –0.44; lower times indicate better performance). The ibuprofen only group showed greater improvements than the placebo group (−11.27-second difference, p = 0.05; Cohen’s d = –0.73; 95% CI, –1.57 to 0.11). Both EXCAP–ibuprofen and EXCAP–placebo participants exhibited improvements on the FACT-Cog “comments from others” compared to placebo (Cohen’s d = 1.00; 95% CI, 0.35 to 1.65 and Cohen’s d = 0.65; 95% CI, –0.01 to 1.31). On Rapid Visual Processing mean latency, participants in the EXCAP-placebo group had a significant improvement compared to placebo (Cohen's d = −1.10; 95% CI, −1.97 to −0.23); those receiving ibuprofen had an improvement compared to placebo, which revealed a trend after adjusting for reading score (Cohen's d = −1.04; 95% CI, −2.06 to −0.01). The ibuprofen group performed less well on the Hopkins Verbal Learning Test-Revised delayed compared to those not receiving ibuprofen (Cohen’s d = –0.64; 95% CI, –1.21 to –0.07).
Conclusions: Exercise and low-dose ibuprofen improved some domains of cognitive function, although effects were not observed across all measures. Phase 3 trials are needed.
Cancer , article en libre accès, 2026