Exercise as an adjunct therapy in melanoma patients undergoing checkpoint inhibitor therapy

Author Identifiers

Brendan Crosby


Date of Award


Degree Type

Thesis - ECU Access Only

Degree Name

Master of Medical and Health Science by Research


School of Medical and Health Sciences

First Advisor

Favil Singh

Second Advisor

Daniel A. Galvão

Third Advisor

Robert U. Newton

Fourth Advisor

Dennis R. Taaffe

Fifth Advisor

Elin Gray


Extensive research has shown that exercise can improve physical, functional, and psychosocial outcomes during cancer treatment. Despite the prevalence of melanoma, exercise as a therapy in the management of this disease remains understudied and underrepresented in current exercise oncology guidelines. Our systematic literature review identified six studies (882 patients) reporting the effects of physical activity and exercise on objectively-measured and patient-reported outcomes among patients with melanoma. Studies presented heterogeneity of design with two cross-sectional surveys, two retrospective analyses, and two non-randomised intervention trials. Findings from this review indicate that physical activity or exercise did not negatively impact quality of life, objectively measured or patient-reported outcomes in patients with melanoma. In our intervention study, ten patients (5 female, 62.2 ± 13.6 years) with advanced melanoma receiving checkpoint inhibitors completed the 8-week single-group telehealth intervention. Intervention sessions were undertaken three times per week (24 sessions) and included supervised comprehensive balance, aerobic, and resistance exercises. The completion rate was 91%, program attendance 88%, average session intensity 76%, with no severe or life-threatening adverse events. Physical function outcomes, aerobic capacity (17.6%, p < 0.001), lower body power (23.2%, p = 0.006), upper body strength (39.6%, p = 0.010), and balance (3.8%, p = 0.007) improved following the intervention. There was no change in quality of life (p = 0.888) or fatigue (p = 0.440), although the decrease in fatigue [(median and IQR, 44.4 (22.2 – 66.7) to 33.3 (19.4 – 47.2)] was clinically meaningful. These findings show that supervised exercise delivered via telehealth to patients with advanced melanoma receiving checkpoint inhibitors is feasible and can improve physical function. Supervised telehealth exercise is safe and can be delivered by an accredited exercise physiologist to improve physical outcomes and preserve quality of life in patients undergoing checkpoint inhibitor treatment.

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