{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:17:23Z","timestamp":1790716643561,"version":"4.1.0"},"reference-count":85,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adjuvant and neoadjuvant treatment for breast cancer (BC) such as chemotherapy and radiotherapy can lead to immune system impairment. Exercise is hypothesized to mitigate these effects by modulating immune responses and reducing chronic inflammation. This review aims to summarize the existing evidence on the impact of physical exercise on inflammatory markers and cellular immune function in patients with BC during prehabilitation, adjuvant or neoadjuvant treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted in PubMed, Web of Science, Scopus and Embase to identify randomized controlled trials investigating exercise interventions in individuals with BC undergoing medical treatment. The included studies assessed outcomes on markers of immune function and inflammation. Subgroup analyses were undertaken for type of training, supervision, risk of bias, timing, duration and intensity of intervention and sample size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty randomized controlled trials, including 1109 participants, were included in this review. Based on the available evidence, no significant influence of exercise on the determined immune factors and markers of inflammation could be confirmed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These meta\u2010analyses suggest that exercise does not significantly alter immune function or markers of inflammation in BC patients during prehabilitation, adjuvant or neoadjuvant treatment. As no negative effect was observed, exercise appears to be safe and should be recommended to patients during cancer treatment because of its beneficial effects on quality of life, fatigue, cancer\u2010related pain and survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.70176","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T08:26:51Z","timestamp":1771057611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exercise\u2010induced immune response in breast cancer patients during prehabilitation, neoadjuvant or adjuvant treatment: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9607-8353","authenticated-orcid":false,"given":"Simone","family":"Ubaghs","sequence":"first","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenza","family":"Mostaqim","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"},{"name":"Flanders Research Foundation\u2010FWO  Brussels Belgium"},{"name":"REVAL Research, Faculty of Rehabilitation Sciences Universiteit Hasselt  Diepenbeek Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Lahousse","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"},{"name":"Flanders Research Foundation\u2010FWO  Brussels Belgium"},{"name":"Department of Physical Medicine and Physiotherapy University Hospital Brussels  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishtiaq","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Polli","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"},{"name":"Flanders Research Foundation\u2010FWO  Brussels Belgium"},{"name":"Department of Public Health and Primary Care, Centre for Environment &amp; Health KU Leuven  Leuven Belgium"},{"name":"Department of Rehabilitation Sciences KU Leuven\u2010University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Fontaine","sequence":"additional","affiliation":[{"name":"Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lore","family":"Dams","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"},{"name":"Department of Rehabilitation Sciences KU Leuven\u2010University of Leuven  Leuven Belgium"},{"name":"Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy University of Antwerp, MOVANT  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1308-6171","authenticated-orcid":false,"given":"Yanthe","family":"Buntinx","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6375-5636","authenticated-orcid":false,"given":"Jolien","family":"Hendrix","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"},{"name":"Flanders Research Foundation\u2010FWO  Brussels Belgium"},{"name":"Department of Public Health and Primary Care, Centre for Environment &amp; Health KU Leuven  Leuven Belgium"},{"name":"Department of Rehabilitation Sciences KU Leuven\u2010University of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joeri","family":"Aerts","sequence":"additional","affiliation":[{"name":"Neuro\u2010Aging &amp; Viro\u2010Immunotherapy (NAVI) Research Group, Faculty of Medicine and Pharmacy Vrije Universiteit Brussel (VUB)  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Huysmans","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"},{"name":"Flanders Research Foundation\u2010FWO  Brussels Belgium"},{"name":"Department of Physical Medicine and Physiotherapy University Hospital Brussels  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Nijs","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy Vrije Universiteit Brussel (VUB)  Brussels Belgium"},{"name":"Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel  Brussels Belgium"},{"name":"Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Breast Cancer","author":"WHO","year":"2021"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01893697-201432010-00004"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011292.pub2"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12195-021-00679-8"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-014-0656-1"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002490"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2024.27.E207"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-015-2763-0"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkac052"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000682"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2019.08.187"},{"issue":"8","key":"e_1_2_12_13_1","first-page":"721","article-title":"Effects of exercise training on fasting insulin, insulin resistance, insulin\u2010like growth factors, and insulin\u2010like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial","volume":"12","author":"Fairey AS","year":"2003","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-016-3688-0"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1249\/01.mss.0000175857.84936.1a"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-12-0278"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-022-02058-5"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2021.155712"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_12_21_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Al HJ","year":"2019"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_12_23_1","unstructured":"AhmedI.Estimating the Pooled Mean and Standard Deviation (SD) following Cochrane Guidelines.https:\/\/ixhtiaq.shinyapps.io\/Pooled_Mean_and_SD_of_2_groups\/."},{"key":"e_1_2_12_24_1","unstructured":"AhmedI.MetaChange: a Shiny app for calculating mean and standard deviation changes in meta\u2010analysis.2023."},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1099800414523489"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2020.01.001"},{"key":"e_1_2_12_27_1","doi-asserted-by":"crossref","unstructured":"DrouinJ.Aerobic exercise training effects on physical function fatigue and mood immune status and oxidative stress in subjects undergoing radiation treatment for breast cancer.2002.","DOI":"10.1097\/01893697-200321010-00017"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534735420977666"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.14280"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-18-3143"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05411-2"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/antiox12051138"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2019.00959"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-6131.36795"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-6131.36789"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/372908"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0025-7826.18.03244-1"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.10.058"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-017-2573-5"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-017-4608-7"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbih.2025.101021"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1158\/2767-9764.CRC-23-0148"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13102-022-00397-2"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7793.2000.00237.x"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2023.08.001"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.14241"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2012.02.001"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2019.00098"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7254.2008.00889.x"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30104"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2023.156303"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.57541"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12227098"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-016-3411-1"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5876-4-48"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1237729"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2006.051292"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.12.077"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.871"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1998.274"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20233"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2005.04.009"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42000-020-00250-6"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5699(93)90245-G"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-199111030-00003"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-0953"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-313"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0722.1997.tb00245.x"},{"key":"e_1_2_12_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00424-022-02760-1"},{"key":"e_1_2_12_70_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-007-0529-1"},{"key":"e_1_2_12_71_1","doi-asserted-by":"publisher","DOI":"10.6091\/ibj.1289.2014"},{"key":"e_1_2_12_72_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-016-0212-9"},{"key":"e_1_2_12_73_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-33432-4"},{"key":"e_1_2_12_74_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199901000-00011"},{"key":"e_1_2_12_75_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200007001-00001"},{"key":"e_1_2_12_76_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40798-022-00419-w"},{"key":"e_1_2_12_77_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-023-07968-0"},{"key":"e_1_2_12_78_1","doi-asserted-by":"publisher","DOI":"10.22088\/cjim.14.3.479"},{"key":"e_1_2_12_79_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02698035"},{"key":"e_1_2_12_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2022.155836"},{"issue":"11","key":"e_1_2_12_81_1","first-page":"4717","article-title":"Immunological similarities between cancer and chronic fatigue syndrome: the common link to fatigue?","volume":"29","author":"Meeus M","year":"2009","journal-title":"Anticancer Res"},{"key":"e_1_2_12_82_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000155666.55034.c6"},{"key":"e_1_2_12_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2015.07.009"},{"key":"e_1_2_12_84_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP281356"},{"key":"e_1_2_12_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(03)00848-9"},{"key":"e_1_2_12_86_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.913176"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.70176","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eci.70176","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.70176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T12:46:29Z","timestamp":1778935589000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.70176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":85,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/eci.70176"],"URL":"https:\/\/doi.org\/10.1111\/eci.70176","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-09-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70176"}}