Abstract 5745: Physical activity is associated with lymphocytic reaction to colorectal cancer: A pilot study
Authors: Holowatyj Andreana N. , Viskochil Richard , Himbert Caroline , Lin Tengda , Ose Jennifer , Peoples Anita R. , Huang Lyen C. , Pickron Bartley , Scaife Courtney , Boehm Juergen , Hardikar Sheetal , Bronner Mary , Figueiredo Jane C. , Li Christopher , Schneider Martin , Shibata David , Siegel Erin , Toriola Adetunji T. , Pletneva Maria , Swanson Eric A. , Ulrich Cornelia M. 
Published: September 2020

Abstract
Background: Increased physical activity (PA) and higher overall tumor lymphocytic reaction score (LRS) are independently associated with improved outcomes in colorectal cancer (CRC) patients. However, the contribution of immune function to energy balance effects on CRC prognosis remains unclear.
Methods: PA was self-reported prior to surgery (baseline) from nineteen stage I-III CRC patients enrolled in the ColoCare Study and computed into metabolic equivalent (MET) hr/week using the VITAL questionnaire. Objective PA measures were assessed using accelerometers (Actigraph GT3X+) worn 24 hr/day for 4+ consecutive days 12 months post-surgery. PA volume and intensity were derived from raw accelerometer data using ActiLife software and Freedson activity cut-points (moderate to vigorous exercise in bouts of &gt;10 min). Clinicodemographic features were assessed by medical chart review. Clinical tumor blocks were pathologically scored for components of lymphocytic reaction (Crohn's-like reaction, peritumoral reaction, intratumoral periglandular reaction, and tumor-infiltrating lymphocytes [TILs]; individually scored: 0-3) and overall LRS (sum score: 0-12). Patients were categorized by mean overall LRS into low (0-4) and high (5-12) LRS groups. Mean and standard deviation values were calculated for PA and clinicodemographic features, and compared by overall LRS group using ANOVA tests. Spearman correlation coefficients were calculated to investigate the association between PA and lymphocytic reaction.
Results: CRC patients were on average 58 years old, obese (mean body mass index=31.1 kg/m2), had a mean overall LRS of 4, reported 13.4 baseline MET hr/week and 11.5 MET hr/week 12 months post-surgery. Baseline body mass index was inversely correlated with intratumoral periglandular reaction (r=-0.32, p=0.002) and overall LRS (r=-0.62, p=0.005). Self-reported baseline MET hr/week had a strong positive correlation with overall LRS (r=0.83, p&lt;0.0001) and with individual immune features (Crohn's-like reaction [r=0.56, p=0.02], intratumoral periglandular reaction [r=0.67, p=0.004], and TILs [r=0.76, p=0.0004]). A moderate positive correlation was observed with MET hr/week reported 12 months post-surgery and overall LRS (r=0.53, p=0.02). Patients in the high overall LRS group (n=7) reported significantly higher MET hr/week compared to patients in the low overall LRS group (n=12) (baseline: 28.1 vs 5.5 MET hr/week, p&lt;0.001; 12 months: 23.5 vs 3.9 MET hr/week, p=0.004). The overall LRS correlated with min/week of exercise measured by accelerometry (r=0.52, p=0.02). Further, exercise min/week statistically significantly differed by overall LRS group (high vs low LRS: 537 vs 217 min/week of exercise; p=0.038).
Conclusion: Together, findings from this pilot study suggest a correlation of energy balance components (PA and body composition) with lymphocytic reaction to colorectal cancer.
Citation Format: Andreana N. Holowatyj, Richard Viskochil, Caroline Himbert, Tengda Lin, Jennifer Ose, Anita R. Peoples, Lyen C. Huang, Bartley Pickron, Courtney Scaife, Juergen Boehm, Sheetal Hardikar, Mary Bronner, Jane C. Figueiredo, Christopher Li, Martin Schneider, David Shibata, Erin Siegel, Adetunji T. Toriola, Maria Pletneva, Eric A. Swanson, Cornelia M. Ulrich. Physical activity is associated with lymphocytic reaction to colorectal cancer: A pilot study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5745.