Trial reportCancer prevention research (Philadelphia, Pa.)2020
Effect of Exercise or Metformin on Biomarkers of Inflammation in Breast and Colorectal Cancer: A Randomized Trial.
Trial report in Cancer prevention research (Philadelphia, Pa.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Association between quality of life and mortality risk in patients with breast cancer: a systematic review and meta-analysis.Breast cancer (Tokyo, Japan) · 2024Pooled it
- Multiparameter MRI assessment of metformin and exercise effects on skeletal muscle in prediabetes: a randomized controlled trial.European radiology experimental · 2025Trial
- A pilot investigation of the impact of acute mental and physical fatigue exposure on inflammatory cytokines and state fatigue level in breast cancer survivors.BMC women's health · 2025Trial
- Inflammation, physical activity, and disease-free survival in stage III colon cancer: Cancer and Leukemia Group B-Southwest Oncology Group 80702 (Alliance).Journal of the National Cancer Institute · 2024Trial
- Effects of exercise or metformin on myokine concentrations in patients with breast and colorectal cancer: A phase II multi-centre factorial randomized trial.Journal of cachexia, sarcopenia and muscle · 2024Trial
- Effect of metformin and lifestyle intervention on adipokines and hormones in breast cancer survivors: a pooled analysis from two randomized controlled trials.Breast cancer research and treatment · 2024Trial
- Physical activity in recurrent colon cancer: Cancer and Leukemia Group B/SWOG 80702 (Alliance).Cancer · 2023Trial
- Article
- Exercise as a Disease-Modifying Therapy in Colon Cancer: Practice-Changing Evidence from the CHALLENGE Trial.Cancers · 2026Review
- Article
- Guidance for protocol content and reporting of factorial randomised trials: explanation and elaboration of the CONSORT 2010 and SPIRIT 2013 extensions.BMJ (Clinical research ed.) · 2025Article
- Repurposing of Metabolic Drugs Metformin and Simvastatin as an Emerging Class of Cancer Therapeutics.Pharmaceutical research · 2025Review
- Tumor bearing in untreated breast cancer decreases exercise tolerance without lowering maximal oxygen uptake in rats.American journal of cancer research · 2025Article
- The Influence of Physical Training on Breast Cancer: The Role of Exercise-Induced Myokines in Regulating Breast Cancer Cell Growth and Survival.International journal of molecular sciences · 2024Article
- Review
- Metformin and the Liver: Unlocking the Full Therapeutic Potential.Metabolites · 2024Review
- Metformin and Breast Cancer: Current Findings and Future Perspectives from Preclinical and Clinical Studies.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Association between physical activity and the time course of cancer recurrence in stage III colon cancer.British journal of sports medicine · 2023Observational
- Elevated C-Reactive Protein and Subsequent Patient-Reported Cognitive Problems in Older Breast Cancer Survivors: The Thinking and Living With Cancer Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- The dose-response effect of aerobic exercise on inflammation in colon cancer survivors.Frontiers in oncology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 7 institutions in 2 countries.
Funding
Abstract
Observational studies report that physical activity and metformin are associated with improved clinical outcome in patients with cancer. Inflammation is one biological mechanism hypothesized to mediate these associations. In this phase II, multicenter, 2 × 2 factorial trial, 139 patients with breast and colorectal cancer who completed standard therapy were randomized to one of four treatment groups for 12 weeks: exercise alone, metformin alone, exercise and metformin, or control. Inflammation outcomes included high-sensitivity C-reactive protein (hs-CRP), soluble tumor necrosis factor alpha receptor two (sTNFαR2), and IL6. The primary modeling strategy evaluated the trial product estimand that was quantified using a generalized linear mixed model. Compared with control, exercise alone reduced hs-CRP [-30.2%; 95% confidence interval (CI), -50.3, -1.0] and IL6 (-30.9%; 95% CI, -47.3, -9.5) but did not change sTNFαR2 (1.0%; 95% CI, -10.4, 13.9). Compared with control, metformin alone did not change hs-CRP (-13.9%; 95% CI, -40.0, 23.4), sTNFαR2 (-10.4%; 95% CI, -21.3, 2.0), or IL6 (-22.9%; 95% CI, -42.3, 2.0). Compared with control, exercise and metformin reduced sTNFαR2 (-13.1%; 95% CI, -22.9, -1.0) and IL6 (-38.7%; 95% CI, -52.3, -18.9) but did not change hs-CRP (-20.5%; 95% CI, -44.0, 12.7). The combination of exercise and metformin was not synergistic for hs-CRP, sTNFαR2, or IL6. In survivors of breast and colorectal cancer with low baseline physical activity and without type 2 diabetes, exercise and metformin reduced measures of inflammation that are associated with cancer recurrence and mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.