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This study explored the effects of physical exercise in patients with testicular cancer during or after BEP-chemotherapy on pulmonary and vascular endothelial toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this post hoc analysis of a multicenter randomized clinical trial (NCT01642680), patients with metastatic testicular cancer scheduled to receive BEP-chemotherapy were randomized to a 24-week exercise intervention, initiated during (group A) or after BEP-chemotherapy (group B). Endpoints were pulmonary function (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), lung transfer-coefficient and transfer factor for carbon monoxide (KCO, DLCO) and markers of vascular endothelial dysfunction (von Willebrand factor (vWF) and factor VIII).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty patients were included. Post-chemotherapy, patients declined less in FVC, FEV1 and DLCO in group A compared to group B. Post-chemotherapy, vWF and factor VIII were significantly lower in group A compared to group B. After completion of exercise, started either during BEP-chemotherapy or thereafter, no between-group differences were found. At 1-year post-intervention, significant between-group differences were found in favour of group A in DLCO and KCO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients who exercised during BEP-chemotherapy better preserved FVC, FEV1 and DLCO, measured directly post-chemotherapy and 1-year post-intervention (DLCO, KCO). This coincided with less increase in vWF and factor VIII measured directly post-chemotherapy. These data support a beneficial role of a physical exercise intervention during BEP-chemotherapy on pulmonary and vascular damage in patients with testicular cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registry<\/jats:title>\n                    <jats:p>\n                      Optimal Timing of Physical Activity in Cancer Treatment (ACT) Registry URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01642680\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01642680<\/jats:ext-link>\n                      . Trial registration number: NCT01642680.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00432-023-05469-5","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:01:40Z","timestamp":1698364900000},"page":"17467-17478","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Physical exercise in patients with testicular cancer treated with bleomycin, etoposide and cisplatin chemotherapy: pulmonary and vascular endothelial function\u2014an exploratory analysis"],"prefix":"10.1007","volume":"149","clinical-trial-number":[{"clinical-trial-number":"nct01642680","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Gabriela G. 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A.M.E. Walenkamp: Grant: Dutch Cancer Society (inst). Research funding: Abbvie (inst), BMS (inst), Genzyme (inst), Karyopharm Therapeutics (inst), Roche (inst). Consulting of advisory role: Polyphor (inst), IPSEN (inst), Karyopharm (inst), Novartis (inst). Prof. Dr. J.A. Gietema: Research funding: Abbvie (inst), Roche (inst), Siemens (inst). No other potential conflicts of interest are reported by any of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Written informed consent was obtained from all patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}