Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regression

ObjectiveThis study aimed to systematically evaluate the effects of exercise interventions on metabolic and inflammatory biomarkers in cancer patients, and to identify potential dose–response relationships and modulatory mechanisms using Robust Variance Estimation (RVE) and MetaForest models.Methods...

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Main Authors: Jingyu Wang, Yuxuan He, Ziqian Wang, Zhouluo Wang, Yongqi Miao, Jae-Young Choi
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1663560/full
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author Jingyu Wang
Yuxuan He
Yuxuan He
Ziqian Wang
Zhouluo Wang
Yongqi Miao
Jae-Young Choi
author_facet Jingyu Wang
Yuxuan He
Yuxuan He
Ziqian Wang
Zhouluo Wang
Yongqi Miao
Jae-Young Choi
author_sort Jingyu Wang
collection DOAJ
description ObjectiveThis study aimed to systematically evaluate the effects of exercise interventions on metabolic and inflammatory biomarkers in cancer patients, and to identify potential dose–response relationships and modulatory mechanisms using Robust Variance Estimation (RVE) and MetaForest models.MethodsA systematic search of five databases was conducted from inception to March 6, 2025, based on the PICOS framework. Randomized controlled trials involving exercise interventions of ≥4 weeks in adults (≥18 years) with cancer were included. Effect sizes were pooled using RVE to estimate overall intervention effects. Risk of bias was assessed using the ROB2 tool, and the certainty of evidence was evaluated with the GRADE approach. Univariable RVE meta-regression was performed to examine the linear effects of each moderator. MetaForest was used to assess variable importance and to explore potential nonlinear relationships between moderators and intervention effects. Subgroup analyses were conducted by cancer type and intervention timing.ResultsA total of 83 eligible articles were included, representing 74 distinct randomized controlled trials, from which data were extracted. Exercise significantly reduced insulin levels (ES = –0.24, SE = 0.08, p < 0.01, I² = 49%), representing a small but meaningful effect. TNF-α showed a small effect (ES = –0.22, SE = 0.13) but was not statistically significant (p = 0.10, I² = 74%). MetaForest modeling revealed that the most favorable changes in IL-6, adiponectin, and IGF-1 were associated with high-intensity aerobic exercise; TNF-α, IL-8, and IL-10 responded best to longer weekly exercise duration; and improvements in glucose, leptin, and CRP were most pronounced when exercise was combined with caloric restriction.ConclusionRegular exercise confers modest but favorable effects on metabolic and inflammatory biomarkers in cancer patients. Meta-regression highlighted the importance of high-intensity aerobic exercise (HRR > 85%) in modulating IL-6, adiponectin, and IGF-1, as well as longer weekly exercise duration (>280 min/week) in improving TNF-α and IL-8. Mechanistically, high-intensity aerobic exercise may serve as a primary trigger for activating pathways that mediate metabolic and inflammatory improvements.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251002676.
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spelling doaj-art-ca27f468eb2f4fa4be8148d98f0b196c2025-08-20T03:36:38ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16635601663560Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regressionJingyu Wang0Yuxuan He1Yuxuan He2Ziqian Wang3Zhouluo Wang4Yongqi Miao5Jae-Young Choi6Department of Sport Leisure, Sungshin Women’s University, Seoul, Republic of KoreaDepartment of Sport Leisure, Sungshin Women’s University, Seoul, Republic of KoreaSchool of Education and Arts, Jiujiang Polytechnic University of Science and Technology, Jiujiang, ChinaDepartment of Sport Leisure, Sungshin Women’s University, Seoul, Republic of KoreaSchool of Philosophy and Sociology, Jilin University, Changchun, ChinaCollege of Physical Education, Jilin University, Changchun, ChinaDepartment of Physical Education, College of Education, Korea University, Seoul, Republic of KoreaObjectiveThis study aimed to systematically evaluate the effects of exercise interventions on metabolic and inflammatory biomarkers in cancer patients, and to identify potential dose–response relationships and modulatory mechanisms using Robust Variance Estimation (RVE) and MetaForest models.MethodsA systematic search of five databases was conducted from inception to March 6, 2025, based on the PICOS framework. Randomized controlled trials involving exercise interventions of ≥4 weeks in adults (≥18 years) with cancer were included. Effect sizes were pooled using RVE to estimate overall intervention effects. Risk of bias was assessed using the ROB2 tool, and the certainty of evidence was evaluated with the GRADE approach. Univariable RVE meta-regression was performed to examine the linear effects of each moderator. MetaForest was used to assess variable importance and to explore potential nonlinear relationships between moderators and intervention effects. Subgroup analyses were conducted by cancer type and intervention timing.ResultsA total of 83 eligible articles were included, representing 74 distinct randomized controlled trials, from which data were extracted. Exercise significantly reduced insulin levels (ES = –0.24, SE = 0.08, p < 0.01, I² = 49%), representing a small but meaningful effect. TNF-α showed a small effect (ES = –0.22, SE = 0.13) but was not statistically significant (p = 0.10, I² = 74%). MetaForest modeling revealed that the most favorable changes in IL-6, adiponectin, and IGF-1 were associated with high-intensity aerobic exercise; TNF-α, IL-8, and IL-10 responded best to longer weekly exercise duration; and improvements in glucose, leptin, and CRP were most pronounced when exercise was combined with caloric restriction.ConclusionRegular exercise confers modest but favorable effects on metabolic and inflammatory biomarkers in cancer patients. Meta-regression highlighted the importance of high-intensity aerobic exercise (HRR > 85%) in modulating IL-6, adiponectin, and IGF-1, as well as longer weekly exercise duration (>280 min/week) in improving TNF-α and IL-8. Mechanistically, high-intensity aerobic exercise may serve as a primary trigger for activating pathways that mediate metabolic and inflammatory improvements.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251002676.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1663560/fullcancermetabolisminflammationexerciseexercise prescription
spellingShingle Jingyu Wang
Yuxuan He
Yuxuan He
Ziqian Wang
Zhouluo Wang
Yongqi Miao
Jae-Young Choi
Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regression
Frontiers in Immunology
cancer
metabolism
inflammation
exercise
exercise prescription
title Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regression
title_full Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regression
title_fullStr Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regression
title_full_unstemmed Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regression
title_short Effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients: a systematic review, meta-analysis, and meta-regression
title_sort effects of different exercise prescription parameters on metabolic and inflammatory biomarkers in cancer patients a systematic review meta analysis and meta regression
topic cancer
metabolism
inflammation
exercise
exercise prescription
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1663560/full
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