August 8 @ 3:00 pm – 4:00 pm
Title: I will survive: challenges of psycho-oncology and supportive care clinical trials
Abstract:
The psychological and physiological impacts of cancer and its treatment are well recognised as contributing to major reductions in quality of life and function amongst cancer survivors. There have been many interventions developed and shown to be efficacious. However, these are too commonly perceived as nice to have added extras rather than core components of cancer treatment and rehabilitation.
Preclinical and observational studies suggest that exercise may improve cancer outcomes. However, definitive level 1 evidence is lacking.
The CHALLENGE trial aimed to determine whether a 3-year structured exercise program improved disease-free and overall survival in people with stage III or high-risk stage II colon cancer who had completed adjuvant chemotherapy when compared with health education materials alone.
RESULTS: From 2009 through 2024, a total of 889 patients underwent randomization to the exercise group (445 patients) or the health-education group (444 patients). At a median follow-up of 7.9 years, disease-free survival was significantly longer in the exercise group than in the health-education group (hazard ratio for disease recurrence, new primary cancer, or death, 0.72; 95% confidence interval [CI], 0.55 to 0.94; P = 0.02). The 5-year disease-free survival was 80.3% in the exercise group and 73.9% in the health-education group (difference, 6.4 percentage points; 95% CI, 0.6 to 12.2). Results support longer overall survival in the exercise group than in the health-education group (hazard ratio for death, 0.63; 95% CI, 0.43 to 0.94). The 8-year overall survival was 90.3% in the exercise group and 83.2% in the health education group (difference, 7.1 percentage points; 95% CI, 1.8 to 12.3). Musculoskeletal adverse events occurred more often in the exercise group than in the health-education group (in 18.5% vs. 11.5% of patients).
CONCLUSIONS: A 3-year structured exercise program initiated soon after adjuvant chemotherapy for colon cancer resulted in significantly longer disease-free survival and findings consistent with longer overall survival.
While the study demonstrated structured exercise is superior to health education alone, there are many lessons to be learnt about conducting supportive care clinical trials like CHALLENGE.
Bio:
Professor Haryana Dhillon(BSc MA PhD) is a Professor in Psycho-Oncology and Chair and Executive Director of the Psycho-Oncology Cooperative Research Group. They co-lead the Survivorship Research Group, University of Sydney. Haryana has received multiple awards for their contribution to cancer research including the 2023 Melanie Price Psycho-Oncology Award from the Clinical Oncology Society of Australia (COSA) and the 2023 John Zalcberg AO Award for Excellence in AGITG Research. They were a finalist in the Eureka Awards category for excellence in Research Supervision and Mentoring (2024 and 2025).
Haryana has an outstanding track record of research and collaboration with more than 265 peer-reviewed publications and >$27 million in research funding. They were the Australian co-PI the practice changing Co.21 CHALLENGE Trial which demonstrated a survival advantage to colon cancer survivors who were randomised to a structured exercise program – a highlight of more than 30 years of working in cancer clinical research.
Haryana’s contributions have extended from informed decision-making, informed consent at diagnosis, intervention development and evaluation, and large scale implementation in supportive care and cancer survivorship. They use a wide range of research methods from exploratory qualitative studies though to large scale randomised controlled trials and implementation science. Haryana led the MRFF Brain Cancer Mission – Survivorship program of work BRAINS (brain cancer rehabilitation, assessment, intervention, and needs in survivorship) bringing together four cooperative trials groups and 11 institutions across Australia to collaborate on five themes of work.
Haryana is the president-elect of COSA and a member of the Board. They previously chaired the Supportive Care and Quality of Life Subcommittee of the Australian New Zealand Urogenitary Prostate Cancer Trials Group and the Thoracic Oncology Group of Australasia. They currently contribute to the Cervical Cancer Clinical Practice Guidelines Working Group and the Rare Cancer Optimal Care Pathway Working Group.
Haryana has more than 30 years experience in cancer clinical research and is passionate about rigor in research, practical solutions to tricky problems, and doing what they can to help humans make it to the 22nd century.