May 11, 2022
By Jimmy O’Hara, Conquer Cancer
Aerobic exercise paired with immunotherapy may prove a promising treatment combination for patients with metastatic melanoma. Exercise can have a profound impact on the tumor microenvironment, and immunotherapy can be effective for patients with melanoma. However, more research is needed to help patients whose tumors are resistant and to expand options for treatment.
“Due to the success of immunotherapy, many people incorrectly assume that more research is not needed in this area. In reality, more than half of patients treated with immunotherapy will not have their tumors controlled and will require other therapy options, which are still very limited,” said Allison Betof Warner, MD, PhD, a medical oncologist at Memorial Sloan Kettering Cancer Center (MSK). “Understanding how to make immunotherapy safer, more tolerable, and more effective are some of the greatest areas of need in melanoma research.”
Using support from a 2018 Young Investigator Award (YIA) from Conquer Cancer, the ASCO Foundation, Dr. Betof Warner is exploring exercise oncology, researching the effects of aerobic exercise on tumor growth and blood supply, drug delivery, and therapeutic efficacy to fill this gap in melanoma care.
Working Toward a Clinical Trial
Dr. Betof Warner and her team at MSK are studying mice implanted with melanoma tumors and testing how multiple exercise-related factors affect tumor growth and efficacy of immunotherapy.
“We are able to manipulate factors like intensity, duration, and frequency of exercise to see how this affects tumor growth and the efficacy of immunotherapy. When completed, this work will help us to design a clinical trial of exercise plus immunotherapy in patients with melanoma,” said Dr. Betof Warner. “Melanoma leads the immunotherapy field, so many of the discoveries we make in melanoma can be translated to help patients with other cancers.”
Conquering Melanoma and Marathons
Many patients seek Dr. Betof Warner’s care because of her interest in exercise oncology. Personal experiences with one such patient, a distance runner recently diagnosed with metastatic melanoma, have resonated with Dr. Betof Warner.
“I reassured her that when we were able to get her cancer under control, I would get her back to running. I joked with her that I would even run a race with her,” said Dr. Betof Warner, a lifelong athlete. “Six months after successful treatment with immunotherapy, she asked me to run the 2021 NYC Marathon together! Seeing my patient with her finisher medal is a moment I’ll never forget.”
Integrating exercise into treatment can also help patients regain a sense of control over their health. The loss of perceived power over one’s wellness while conquering cancer is challenging for many of Dr. Betof Warner’s patients. Seeing her patients re-establish control over their health is at the heart of all Dr. Betof Warner does to improve cancer care.
“One of the most impactful things my marathon-running patient said was that from day one, I empowered her to take control of her cancer and her journey,” said Dr. Betof Warner. “To know that I was able to give that back to even one patient makes every step of this journey worth it.”
Next Steps: Prescribing Exercise
As Dr. Betof Warner continues her YIA research, she aims to implement exercise-related counseling into immunotherapy care plans for patients with melanoma. This innovation could lead to lasting, durable outcomes for many patients.
“I hope that in the near future, we will be able to better counsel patients with melanoma (and other cancers treated with immunotherapy) on an ‘exercise prescription,’” said Dr. Betof Warner. “I’m so grateful to Conquer Cancer donors for enabling my colleagues and me to do the critical work needed to save patients’ lives.”