Over the years, advancements in antiemetic drugs have improved chemotherapy-induced nausea and vomiting (CINV) control. However, despite the antiemetics therapies, in a relevant number of adult patients (∼30 %), CINV is still persistent, leading to several complications, such as electrolyte imbalances, anorexia, and treatment discontinuation. Supportive care interventions have gained credibility in cancer care, helping to improve patients' psycho-physical condition, quality of life, and managing symptoms, including CINV. Physical exercise and tailored nutritional counseling have demonstrated benefits in reducing the severity of nausea and vomiting. Psychological intervention has been postulated as a key approach in controlling anticipatory nausea/vomiting, as well as acupuncture/acupressure has been shown to decrease nausea and vomiting after chemotherapy treatments. In the current review, we aim to provide a clinical update on current prophylactic and delayed antiemetic guidelines for CINV and an overview of the non-pharmacological interventions tested for alleviating CINV in patients with cancer.

Purpose Cardiovascular diseases are a leading cause of non-cancer mortality among patients with cancer, with cardiac autonomic dysfunction identified as a significant predictor of future cardiovascular conditions. Despite the importance of autonomic dysfunction as a prognostic marker being well-established in healthy individuals and other chronic conditions, its role in patients with cancer remains underexplored. This narrative review aims to synthesize existing literature on the role of cardiac autonomic dysfunction in patients with cancer and explore the potential of physical exercise as a non-pharmacological intervention to modulate the autonomic nervous system positively. Methods This review examines methods for assessing cardiac autonomic dysfunction, the factors contributing to its dysregulation, and the prognostic role of heart rate variability. It also analyzes current evidence on the effectiveness of various physical exercise modalities, including aerobic, resistance training, and mind-body interventions, in modulating autonomic function. Results Patients with cancer are exposed to disease-related, lifestyle, and physiological factors that impair autonomic regulation. This dysfunction is associated with worse outcomes, such as increased mortality and disease progression. Preliminary evidence suggests that physical exercise, particularly a combination of aerobic and resistance training, as well as yoga, may improve heart rate variability and mitigate sympathovagal imbalance in patients. Conclusion While research on the effects of physical exercise on autonomic modulation in cancer patients is still limited, early findings show promise. Further studies are needed to fully understand the mechanisms through which exercise improves cardiac autonomic function and its long-term benefits in oncology, positioning this as a novel area of research.

Interleukin-8 (IL-8/CXCL8) drives tumor progression via CXCR1/2 signaling, promoting proliferation, invasion, angiogenesis, and recruitment of pro-tumoral immune and stromal cells. Accumulating clinical evidence indicates that elevated circulating or intratumoral IL-8 levels are consistently associated with adverse prognosis and reduced therapeutic benefit across principal solid tumors. In particular, IL-8 has emerged as a promising prognostic and predictive biomarker of resistance to immune checkpoint inhibitors. This review highlights its prognostic and predictive value across gastrointestinal, genitourinary, lung, melanoma, breast, ovarian, and head and neck cancers, and discusses strategies targeting IL-8 and the need for standardized, clinically actionable assays.

Whereas an exercise intervention effectively improves patients’ quality of life, little information is available about the contribution of each physical fitness component. This study aims to explore the association between physical fitness components and the quality-of-life domain in patients with cancer. Between September 2021 and August 2023, 160 patients with mixed cancer types visiting the Oncology Unit were selected on a consecutive basis according to selection criteria. They underwent a comprehensive baseline assessment including the six-minute walking test, the handgrip strength test, the isometric leg press test, the back scratch, sit and reach tests, their waist–hip ratio, and their body mass index. The European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire was used to measure the quality of life. The sample size was based on the use of regression models to study associations between clinical characteristics and fitness outcomes. All of the analyses were performed using the SPSS v.25 statistical package. Patients had a mean age of 58 years, 68% were female, 42% were affected by breast cancer, and all were receiving anticancer treatments. Higher functional capacity was associated with better global health status (p < 0.0001) and physical (p < 0.0001), role (p < 0.0001), emotional (p = 0.026), and social function (p = 0.016) and inversely linked with fatigue (p = 0.001). Lower-limb flexibility was significantly associated with all of the domains except for role and social functions. The waist–hip ratio was inversely associated with physical function (p < 0.0001) and positively related to fatigue (p = 0.037). Exercise programs aiming to improve the quality of life in cancer should be addressed to optimize these fitness components.

With a dismal prognosis of 8-10 % 5-year survival since diagnosis, pancreatic cancer remains one of the most aggressive oncological diseases. This work aimed to evaluate the effects of exercise medicine on safety and feasibility, physical fitness, body composition, patient-reported outcomes, and clinical outcomes across different treatment phases in patients with pancreatic cancer. PubMed, Cochrane, and Scopus databases were systematically screened to identify single-arm studies and randomized/non-randomized controlled trials investigating a physical exercise intervention in patients with pancreatic cancer. The RoB 2 and ROBINS-I tools were used to evaluate study quality for randomized and non-randomized studies, respectively. Qualitative and quantitative synthesis approaches were used. Among the 5550 identified records, 11 randomized controlled trials and 6 non-randomized studies were considered eligible. Five investigations were conducted in the neoadjuvant setting, eight in the rehabilitative and three during palliative phases. Regarding neoadjuvant exercise, there were no significant changes in cardiorespiratory fitness and muscle strength, whilst a gain in muscle mass was detected. Similarly, in the rehabilitative setting, mixed results were observed for cardiorespiratory fitness and body composition; a positive impact was registered in strength, glucose levels, tryptophan metabolism, and quality of life after 3 months of intervention. In the palliative setting, significant improvements were observed for muscle strength and quality of life, but not for clinical outcomes. Although physical exercise may ameliorate sequelae of pancreatic cancer, further investigation is necessary to understand the real impact of exercise medicine interventions in this population and across different treatment phases.

Background/Objectives: Exercise is a supportive strategy for patients with cancer; however, evidence in individuals with established cancer cachexia remains limited. This study aimed to provide a preliminary description of feasibility and exploratory changes during a supervised exercise program in patients with cancer cachexia. Methods: Five women diagnosed with gastrointestinal or breast cancer and meeting the diagnostic criteria for cancer cachexia participated in a 12-week supervised exercise program, combining aerobic with resistance training, conducted twice weekly. Feasibility outcomes included completion, attendance, adherence, and adverse events. Muscle strength, flexibility, body composition, functional capacity, and patient-reported outcomes were assessed at baseline and post-intervention. Results: All participants completed the intervention and post-intervention assessments. Attendance ranged from 54% to 96%, with interruptions primarily related to treatment schedules and treatment-related side effects. No serious exercise-related adverse events occurred. Functional capacity improved in all participants (+ 33 to +73 m). Grip strength increased in all patients for the right hand (+0.5 to +5.5 kg) and in three patients for the left hand (+2.0 to +3.5 kg). Body composition responses were heterogeneous: fat-free mass increased in three patients (+1.3 to +2.8 kg), whereas two patients showed reductions. Fat mass decreased in three patients (−2.6 to −5.0 kg) and increased in two. Several domains of quality of life and symptom burden improved in most participants. Conclusions: In these five women with cancer cachexia, a supervised exercise program showed variable attendance and no serious exercise-related adverse events, whereas favorable changes for functional outcomes and heterogeneous response in body composition were observed.