Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Prospective observational study of physical activity patterns and fatigue during immunotherapy for stage III and IV melanoma – trial in progress (#567)

Sarah Marvin 1 , Jasmine Yee 1 2 , Jia (Jenny) Liu 3 4 , Georgina Long 5 , Alexander Menzies 5 , Kate Edwards 1 6
  1. Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
  2. Psycho-Oncology Cooperative Research Group, School of Psychology, The University of Sydney, Camperdown, NSW, Australia
  3. The Kinghorn Cancer Centre, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
  4. St Vincent's Clinical School, University of NSW, Darlinghurst, NSW, Australia
  5. Melanoma Institute Australia, Wollstonecraft, NSW, Australia
  6. Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia

Background: Immunotherapy is associated with side-effects including fatigue. The benefits of physical activity in mitigating fatigue are well established among other cancer and treatment types. However, this relationship is not well understood in people with stage III-IV melanoma.

Aims: This study examined the relationship between physical activity and fatigue in individuals receiving immunotherapy treatment for stage III-IV melanoma.

Methods: Adults (n=21) with stage III-IV melanoma (ECOG 0-2) commencing immunotherapy were recruited and followed across their first four immunotherapy cycles (C1-4). Moderate-to-vigorous physical activity (MVPA) was measured using a Fitbit activity monitor. Meeting physical activity guidelines of 150-minutes of MVPA per week was calculated for each cycle. Fatigue was measured at C1-4 and 1-week post-C1-4 using the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F). Clinically significant fatigue was defined as FACIT-F <34.

Results: Average weekly minutes of MVPA was 129-minutes (±146-minutes). 45% met MVPA guidelines in ≥1 cycle; however, only 15% consistently met guidelines in every cycle. Average weekly MVPA did not vary significantly between cycles (p=0.652). Clinically significant fatigue was reported by 48% at ≥1 cycle, with 14% reporting clinically significant fatigue across consecutive timepoints. There was no significant effect of cycle number on fatigue (p=0.999). Individuals who met physical activity guidelines reported significantly lower fatigue levels (p=0.012, d=1.28). There were no significant differences in average MVPA (p=0.968) or fatigue (p=0.420) between participants receiving immunotherapy for metastatic or adjuvant melanoma. Four participants discontinued treatment between C1-C4 due to treatment-related side-effects.

Conclusions: Clinically significant levels of fatigue are common in people with stage III-IV melanoma receiving immunotherapy, with most engaging in insufficient levels of physical activity. Preliminary findings suggest a positive relationship between physical activity and fatigue. Further analyses will be conducted in a larger sample and will include analysis of treatment-related toxicities.