In a Phase 2 Zelen trial, 131 multiple myeloma survivors who had completed treatment at least six weeks prior or were on maintenance therapy, were enrolled to assess the impact of a tailored six-month exercise program consisting of aerobic and resistance training compared to usual care. The primary focus was on changes in the FACIT-F fatigue score, where higher scores indicate less fatigue, alongside evaluations of muscle strength and cardiovascular fitness.

The results indicated that while there was no significant difference in fatigue levels between the exercise and usual care groups at both 3 and 6 months, improvements were noted in muscle strength and cardiovascular fitness in the exercise group. Specifically, muscle strength increased significantly at both 3 months (8.4 kg) and 6 months (10.8 kg), and cardiovascular fitness improved at 3 months (by 1.2 ml/kg/min). A trend towards reduced fatigue was observed over 6 months in the 17 participants who had clinical fatigue at baseline, suggesting that exercise may benefit those with notable fatigue. The study highlights the need for future research to particularly focus on patients with multiple myeloma with clinical fatigue to potentially yield more definitive benefits.

Reference: Koutoukidis DA, Land J, Hackshaw A, et al. Fatigue, quality of life and physical fitness following an exercise intervention in multiple myeloma survivors (MASCOT): an exploratory randomised Phase 2 trial utilising a modified Zelen design. Br J Cancer. 2020 Jul;123(2):187-195. doi: 10.1038/s41416-020-0866-y. Epub 2020 May 21. PMID: 32435057; PMCID: PMC7374110.