New Alliance Clinical Trial Studies Impact of Exercise on Cancer Patients
DEFEND study to test if telehealth exercise plan can be successfully delivered to patients receiving chemotherapy  

November 3, 2025 – The Alliance for Clinical Trials in Oncology has launched a new clinical trial seeking to evaluate the feasibility of delivering a structured exercise program entirely through telehealth for patients with cancer receiving chemotherapy with the ultimate goal of reducing fatigue and disability.

The DEFEND (distance-based exercise to preserve function and prevent disability), trial (Alliance A222302) aims to enroll participants between the ages of 18 and 65 who are receiving chemotherapy with curative intent. The study will assess whether virtual exercise sessions, consisting of supervised resistance and aerobic exercise training, can successfully be delivered to patients during treatment. The study will also explore whether the exercise program can help patients maintain physical function, reduce fatigue and prevent disability during treatment, providing critical data to inform the design of a subsequent phase III trial powered to evaluate the impact of exercise on these outcomes.

“Unlike traditional in-person rehabilitation programs, DEFEND aims to leverage telemedicine to bring exercise directly into patients’ homes,” said Alliance study co-chair Jennifer Ligibel, MD, Professor at Harvard Medical School and a Senior Physician in the Breast Oncology Center at the Dana-Farber Cancer Institute. “Participants will engage in twice-weekly supervised resistance and aerobic training sessions via video calls, guided by trained staff. They’ll also complete additional aerobic sessions on their own, with support and instruction provided remotely.”

As part of the trial, each participant will receive resistance bands and a stationary bike and wear an activity monitor (Fitbit) throughout the study to track physical activity. They will work with an oncology-trained exercise coach based at Dana-Farber.

“Our hybrid model aims to overcome common barriers to exercise during cancer treatment, such as transportation challenges, fatigue from treatment and scheduling conflicts,” said Alliance study co-chair Kathryn Schmitz, PhD, MPH, Interim Director of the UPMC Hillman Cancer Center and Founding Director of the UPMC Moving Through Cancer (Exercise Oncology) Program. “By offering a home-based approach, we hope to make physical activity more accessible and sustainable for a representative population of cancer patients.”

The primary objective of the DEFEND trial is to establish the feasibility of implementing a virtual exercise intervention in a representative cohort of cancer patients. Secondary goals include assessing recruitment and retention of participants, including those from rural areas and underserved communities.

Exploratory outcomes will examine changes in physical function, such as grip strength and distance covered in the 6-Minute Walk Test, as well as self-reported physical activity levels. Researchers will also explore shifts in patient-reported outcomes and employment status over time.

This trial builds on a growing body of evidence showing that exercise can help alleviate treatment-related side effects and improve quality of life for cancer patients. However, few studies have tested scalable, remote delivery models that could be integrated into routine oncology care.

The DEFEND trial is particularly timely as healthcare systems continue to embrace telehealth solutions to reach patients who do not live near or are unable to travel to academic medical centers. If successful, the study could pave the way for broader adoption of virtual exercise programs as a standard component of cancer treatment.

The trial is expected to begin enrolling participants in late 2025, with primary completion anticipated by January 2027. The exercise program will take place over the course of chemotherapy, with a maximum duration of six months. Participants will undergo study assessments at baseline, the end of chemotherapy, and three months after chemotherapy ends.

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Reference: Alliance A222302/ NCT07059884-Distance-based exercise to preserve function and prevent disability (DEFEND)

The Alliance for Clinical Trials in Oncology is a national leader in advancing cancer research, uniting more than 25,000 cancer specialists at 115 main institutions and 1,400 affiliates across the U.S. and Canada. As part of the National Clinical Trials Network and a leading research base for the NCI Community Oncology Research Program, the Alliance conducts pioneering, practice-changing clinical trials that improve outcomes and reshape standards of care. Our work has led to multiple FDA approvals, influenced national guidelines, and produced hundreds of high-impact publications. More than 40,000 participants have taken part in Alliance studies, and our growing biospecimen repository now includes more than 1.5 million samples, collected over the past 30 years. Learn more at www.AllianceforClinicalTrialsinOncology.org.