PhD Scientific Days 2024

Budapest, 9-10 July 2024

Pathological and Oncological Sciences I.

Exercise as Potent Modulator of Tumor Perfusion and the Vascular Tumor Micro-environment - Preliminary Findings From a Young Choroid Melanoma Case in The EyeCanMoveiT Project.


Michael Mendes Wefelnberg1, Damir Zubac2, Johanna Hubert2, Freerk T. Baumann2, Ludwig M. Heindl2, Alexander Rokohl2
1: University of Cologne/University Hospital Cologne
2: University Hospital Cologne

Text of the abstract

Introduction: A hypoxic tumor environment (TE) a result of impaired micro-vasculature, significantly impacts tumor progression and treatment efficacy, prevalent in up to 60% of solid and 70% of metastatic tumors. Although rodent models suggest exercise may enhance tumor perfusion and remodel the TE, confirming these hypotheses in humans, with their complex metabolism, remains challenging. Choroid melanoma (CM), a rare eye cancer, offers a unique opportunity to investigate vascular adaptations using innovative vessel analytical techniques.
Aim: To assess the acute and long-term effects of high-intensity endurance exercise (HIIT) on vascular function and perfusion patterns within the TE of a 30-year-old CM patient, with the healthy eye serving as a control.
Methods: Examining changes in the TE in vivo in a choroid melanoma patient using optical coherence tomography angiography (OCTA), dynamic retinal vessel analyzer (DRVA), and cardio-pulmonary exercise testing (CPET) on a stationary bicycle ergometer. Acute assessments involved OCTA scans before, immediately after, and 30 minutes post one 30-minute bout of HITT. Pre-post evaluations occurred at baseline, post-radiotherapy, post-8-week exercise intervention, and 6-month follow-up.
Results: Following the 8-week exercise regimen, significant enhancements were observed in cardiorespiratory fitness and endothelial function parameters in both eyes (~100%), with even greater improvements noted in the tumor eye. These improvements remained stable at the 6-month follow-up. Additionally, V̇O2 uptake increased by ~7 mL·kg·min-1, and peak power output surged by 50 W. Acute OCTA measurements showed initial perfusion increases post-HIIT, followed by a decline below baseline after 30 minutes of rest, consistent across both eyes, even in very close proximity to the tumor. Moreover, arterial and venous dilation in response to FID stimulus exhibited a twofold increase compared to baseline levels.
Conclusion: Our findings suggest CM as a promising model for studying exercise effects on the tumor micro-environment in vivo using OCTA and DRVA techniques. Nevertheless, detailed analysis of different OCTA layer images and larger patient cohorts are imperative to validate our preliminary results of the EyeCanMoveiT Project (Clinical Trial Register ID: DRKS00031207).
Funding: This project is solely funded by internal resources.