J Natl Compr Canc Netw

Exercise intervention mitigates 'chemo brain' in phase 3 trial

March 13, 2026

A multicenter phase 3 randomized trial found that a 6‑week home‑based exercise program (EXCAP)—individualized walking plus simple resistance‑band exercises—significantly reduced cancer-related cognitive impairment (CRCI) and mental fatigue in patients starting chemotherapy, particularly those on 2‑week cycles. Among 687 participants from 20 U.S. community oncology practices, patients on 2‑week schedules showed meaningful improvements in overall cognitive impairment (mean difference 7.0; P=.04), perceived impairment (4.1; P=.05), comments from others (0.6; P=.02), and mental fatigue (−1.6; P<.01) compared with usual care. All EXCAP participants, regardless of cycle length, reported reduced mental fatigue (−0.7; P=.02). Inflammatory patterns were also linked to outcomes: suppressed inflammatory responses were associated with worse CRCI, while healthier immune activity correlated with better cognitive function.

Clinical takeaway: Encourage patients—especially those on 2‑week chemotherapy cycles—to incorporate light, structured walking and resistance‑band exercises to help preserve cognition and reduce mental fatigue.

Source:

Mustian, KM, et al. (2026, March 12). J Natl Compr Canc Netw. Effects of Exercise on Cognitive Impairment in Patients Receiving Chemotherapy: A Multicenter Phase III Randomized Controlled Trial. https://jnccn.org/view/journals/jnccn/24/3/article-p91.xml