Exercise and pathologic complete response to cancer treatment: a systematic review and meta-analysis

Does exercise during neoadjuvant chemotherapy improve pathologic complete response in people with solid tumors?

504 patients across 8 randomized — what this means trials, with breast, esophageal, gastric, or rectal cancer receiving neoadjuvant chemotherapy

Systematic review — what this means and meta-analysis — what this means of RCTs — what this means comparing aerobic and resistance exercise during chemotherapy with usual care — what this means; databases searched through May 2025

• No difference in pathologic complete response between exercise and control (pooled RR 1.08, 95% CI — what this means 0.82–1.43; Z = 0.56, p = 0.58)
• Exploratory meta-regression in 4 breast cancer studies (367 participants) suggested a possible association with better tumor response in HR+/HER2- subtype (coefficient 0.83, 95% CI — what this means -0.00 to 1.67, p = 0.05)
• Evidence certainty was rated low with few included trials

Current evidence does not show that exercise during neoadjuvant chemotherapy changes tumor response, so its role in oncology rehab appears tied to other outcomes rather than treatment efficacy.