264P Impact of a cardio-oncology rehabilitation framework among high cardiovascular risk breast cancer survivors

Breast cancer (BC) survivors often present increased cardiovascular (CV) risk. Only recently a cardio-oncology rehabilitation-based framework for cancer patients at increased CV risk was proposed. We aimed to compare a center-based cardiac rehabilitation (CBCR) program compared with a community-based exercise training (CBET) on BC survivors. An exploratory analysis of the breast cancer survivors included in the CORE trial (NCT05132998) is presented. CORE was a single-center, randomized controlled trial enrolling high CV risk adult cancer survivors. Participants were randomized to an 8-week CBCR (including ET, psychological management, and health education) or CBET, twice a week. Primary endpoint was cardiorespiratory fitness (CRF) (assessed by the VO2peak, derived from a symptom-limited cardiopulmonary exercise test). Secondary endpoints included changes in quality of life (QoL), asthenia, and muscle strength. Fifty-one BC survivors were included (CBCR=24, CBET=27), mean age of 54 years old ± 9 (range 34-76). All patients underwent surgery. Majority of patients had stage 1 disease (CBCR 50%, CBET 63%), underwent (neo)adjuvant anthracyclines (CBCR 88%, CBET 93%) and adjuvant radiotherapy (CBCR 88%, CBET 82%). Regarding cardiovascular risk factors, dyslipidemia was the most prevalent risk factor (CBCR 46%, CBET 44%), followed by arterial hypertension (CBCR 46%, CBET 33%). Both arms well balanced. There was a significant difference between groups in VO2peak, in favor of the CBCR (p=0.035). We observed a significant improvement in QoL (p=0.003) and asthenia (p=0.004), in CBCR arm while no difference in muscle strength (p=0.786). No serious adverse events were reported. BC survivors benefited from CBCR in terms of CRF. Given the high cardiovascular risk in this specific group patients, this data provides novel insights into optimized preventive strategies in this patient population. Furthermore, the improvement observed in QoL and asthenia is of clinical importance and might correlate with a positive impact in the interference of activities of daily living.