{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:18:49Z","timestamp":1782317929397,"version":"3.54.5"},"reference-count":32,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,18]],"date-time":"2021-12-18T00:00:00Z","timestamp":1639785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010582","name":"NCI","doi-asserted-by":"publisher","award":["5P30CA056036"],"award-info":[{"award-number":["5P30CA056036"]}],"id":[{"id":"10.13039\/100010582","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Cancer therapies are associated with multiple adverse effects, including (but not limited to) cancer-related fatigue (CRF). Fatigue is one of the most common side effects of immune checkpoint inhibitors (ICIs), occurring in up to 25% of patients. Physical activity has been shown to help reduce CRF through modulating the immune system, and may synergistically aid in the anti-tumor effects of ICIs. This review describes the nature and scope of evidence for the effects associated with concurrent physical activity while undergoing ICI therapy. Method: Scoping review methodology was utilized to identify studies, extract data, and collate and summarize results. Results: In literature published from January 2010 through to August 2021, only one human study and three pre-clinical studies met inclusion criteria. Conclusion: Existing evidence supports that physical activity is associated with decreased treatment-related toxicities such as CRF. However, further investigation is warranted. The dearth of clinical studies illustrates the need for more research to address this question, to guide patients and their providers in the application of appropriate physical activity interventions in those patients undergoing ICI.<\/jats:p>","DOI":"10.3390\/cancers13246364","type":"journal-article","created":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T20:41:55Z","timestamp":1639946515000},"page":"6364","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The Effects of Physical Activity on Cancer Patients Undergoing Treatment with Immune Checkpoint Inhibitors: A Scoping Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0263-8708","authenticated-orcid":false,"given":"Amy L.","family":"Shaver","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical College, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8138-6184","authenticated-orcid":false,"given":"Swapnil","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical College, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Nikita","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical College, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Lefler","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical College, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atrayee","family":"Basu-Mallick","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical College, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical College, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Butryn","sequence":"additional","affiliation":[{"name":"Department of Psychology, Drexel University, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2925-7737","authenticated-orcid":false,"given":"Grace","family":"Lu-Yao","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Sidney Kimmel Medical College, Philadelphia, PA 19107, USA"},{"name":"Jefferson College of Population Health, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Vaddepally, R.K., Kharel, P., Pandey, R., Garje, R., and Chandra, A.B. (2020). Review of Indications of FDA-Approved Immune Checkpoint Inhibitors per NCCN Guidelines with the Level of Evidence. Cancers, 12.","DOI":"10.3390\/cancers12030738"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1200\/JCO.19.02105","article-title":"Efficacy of Pembrolizumab in Patients with Noncolorectal High Microsatellite Instability\/Mismatch Repair\u2013Deficient Cancer: Results from the Phase II KEYNOTE-158 Study","volume":"38","author":"Marabelle","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"945","DOI":"10.6004\/jnccn.2010.0069","article-title":"Exercise programs for cancer-related fatigue: Evidence and clinical guidelines","volume":"8","author":"McNeely","year":"2010","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"E54","DOI":"10.1188\/15.ONF.E54-E62","article-title":"Walking Improves Sleep in Individuals with Cancer: A Meta-Analysis of Randomized, Controlled Trials","volume":"42","author":"Chiu","year":"2015","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1007\/s40279-014-0207-5","article-title":"Exercise Intervention Studies in Patients with Peripheral Neuropathy: A Systematic Review","volume":"44","author":"Streckmann","year":"2014","journal-title":"Sports Med."},{"key":"ref_6","first-page":"20","article-title":"Exercise and Cancer-related Fatigue","volume":"5","author":"Mustian","year":"2009","journal-title":"US Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e001872","DOI":"10.1136\/jitc-2020-001872","article-title":"Exercise and the immune system: Taking steps to improve responses to cancer immunotherapy","volume":"9","author":"Gustafson","year":"2021","journal-title":"J. Immunother. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1249\/MSS.0000000000002117","article-title":"American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control","volume":"51","author":"Patel","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0034-1389972","article-title":"Exercise Intensity Guidelines for Cancer Survivors: A Comparison with Reference Values","volume":"35","year":"2014","journal-title":"Int. J. Sports Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Peters, D.M., Godfrey, C., McInerney, P., Soares, B.C., Khalil, H., and Parker, D. (2020). Chapter 11: Scoping Reviews. JBI Manual for Evidence Synthesis, JBI.","DOI":"10.46658\/JBIRM-20-01"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: Towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"Int. J. Soc. Res. Methodol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: Advancing the methodology","volume":"5","author":"Levac","year":"2010","journal-title":"Implement. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/XEB.0000000000000050","article-title":"Guidance for conducting systematic scoping reviews","volume":"13","author":"Peters","year":"2015","journal-title":"Int. J. Evid. Based Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11124\/jbisrir-2016-2838","article-title":"In no uncertain terms: The importance of a defined objective in scoping reviews","volume":"14","author":"Peters","year":"2016","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s41182-019-0165-6","article-title":"A step by step guide for conducting a systematic review and meta-analysis with simulation data","volume":"47","author":"Tawfik","year":"2019","journal-title":"Trop. Med. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1080\/0284186X.2020.1817550","article-title":"Voluntary wheel running can lead to modulation of immune checkpoint molecule expression","volume":"59","author":"Bay","year":"2020","journal-title":"Acta Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1158\/2326-6066.CIR-20-0499","article-title":"Exercise training improves tumor control by increasing CD8+ T-cell infiltration via CXCR3 signaling and sensitizes breast cancer to immune checkpoint blockade","volume":"9","author":"Amoozgar","year":"2021","journal-title":"Cancer Immunol. Res."},{"key":"ref_20","first-page":"100","article-title":"Benefits of exercise and immunotherapy in a murine model of human non-small-cell lung carcinoma","volume":"26","author":"Coronado","year":"2020","journal-title":"Exerc. Immunol. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1007\/s00520-018-4524-3","article-title":"A supportive care intervention for people with metastatic melanoma being treated with immunotherapy: A pilot study assessing feasibility, perceived benefit, and acceptability","volume":"27","author":"Lacey","year":"2019","journal-title":"Support. Care Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3747\/co.19.912","article-title":"Exercise in Clinical Cancer Care: A Call to Action and Program Development Description","volume":"19","author":"Mina","year":"2012","journal-title":"Curr. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.bbi.2009.02.011","article-title":"Acute exercise mobilises CD8+ T lymphocytes exhibiting an effector-memory phenotype","volume":"23","author":"Campbell","year":"2009","journal-title":"Brain Behav. Immun."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40425-017-0231-8","article-title":"A systems biology approach to investigating the influence of exercise and fitness on the composition of leukocytes in peripheral blood","volume":"5","author":"Gustafson","year":"2017","journal-title":"J. Immunother. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3082","DOI":"10.3389\/fimmu.2019.03082","article-title":"Systemic \u03b2-Adrenergic Receptor Activation Augments the ex vivo Expansion and Anti-Tumor Activity of V\u03b39V\u03b42 T-Cells","volume":"10","author":"Baker","year":"2019","journal-title":"Front Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Donovan, T., Bain, A.L., Tu, W., Pyne, D.B., and Rao, S. (2021). Influence of Exercise on Exhausted and Senescent T Cells: A Systematic Review. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.668327"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"452","DOI":"10.18632\/oncotarget.27464","article-title":"Exercise reduces immune suppression and breast cancer progression in a preclinical model","volume":"11","author":"Wennerberg","year":"2020","journal-title":"Oncotarget"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1249\/MSS.0000000000001446","article-title":"Exercise Prescription and Adherence for Breast Cancer: One Size Does Not FITT All","volume":"50","author":"Kirkham","year":"2018","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1097\/JTO.0000000000000536","article-title":"Increasing Physical Activity and Exercise in Lung Cancer: Reviewing Safety, Benefits, and Application","volume":"10","author":"Bade","year":"2015","journal-title":"J. Thorac. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1182\/bloodadvances.2020004018","article-title":"Caloric and nutrient restriction to augment chemotherapy efficacy for acute lymphoblastic leukemia: The IDEAL trial","volume":"5","author":"Orgel","year":"2021","journal-title":"Blood Adv."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12955-018-0882-2","article-title":"Effect of exercise on pain and functional capacity in breast cancer patients","volume":"16","author":"Reis","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1634\/theoncologist.2019-0262","article-title":"Effects of Exercise on Chemotherapy Completion and Hospitalization Rates: The OptiTrain Breast Cancer Trial","volume":"25","author":"Mijwel","year":"2019","journal-title":"Oncologist"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/24\/6364\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:51:34Z","timestamp":1760169094000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/24\/6364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,18]]},"references-count":32,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["cancers13246364"],"URL":"https:\/\/doi.org\/10.3390\/cancers13246364","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,18]]}}}