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Researchers at the National Center for Tumor Diseases (NCT) Heidelberg, the German Cancer Research Center (DKFZ), and Heidelberg University Hospital (UKHD) have investigated how physical exercise during chemotherapy affects the course of breast cancer in the BENEFIT study. They concluded that physical training causes tumors to shrink more in patients with certain breast cancer characteristics than in the control group.

The National Center for Tumor Diseases (NCT) Heidelberg is a joint institution of the German Cancer Research Center (DKFZ), Heidelberg University Hospital (UKHD), the Medical Faculty of Heidelberg University, and the Thorax Clinic Heidelberg.

The positive effect of exercise on the physical and mental well-being and quality of life of cancer patients has been proven in many studies. Based on this, researchers at the NCT Heidelberg, the DKFZ, and the UKHD wanted to find out to what extent exercise could also reduce the growth and spread of a tumor or enhance the success of chemotherapy. Research on mice as well as preclinical and epidemiological studies suggest that this effect may exist. However, there have been very few randomized clinical trials with cancer patients to date.

This is where the BENEFIT study comes in, jointly led by Karen Steindorf, Department of Exercise, Prevention Research and Cancer at the DKFZ and NCT Heidelberg, and Joachim Wiskemann, AG Oncological Sports and Exercise Therapy at the UKHD and NCT Heidelberg. In the BENEFIT study, their teams investigated how systematic physical training by breast cancer patients during neoadjuvant chemotherapy, i.e., chemotherapy before surgery, affects the tumor. The study design of BENEFIT offers the opportunity to evaluate success parameters known from drug studies, such as the complete disappearance of the tumor, known as complete remission, or tumor size in the context of the effect of physical training.

In BENEFIT, 180 patients with non-metastatic breast cancer were randomized, i.e., randomly assigned to one of three groups, before starting neoadjuvant chemotherapy. Groups 1 and 2 received an exercise intervention during the chemotherapy period, either guided strength training or endurance training. The third group received strength training after chemotherapy and surgery and served as the control group for the current study. During the course of the study, no adverse complications or events related to training occurred in either the endurance or strength training group, so physical training can also be considered safe during neoadjuvant chemotherapy.

Depending on the characteristics of the breast cancer, the training program had different effects during chemotherapy. When all study participants were considered together, there were therefore no significant effects on tumor size. However, in patients with hormone receptor-positive tumors, the training interventions were associated with a greater reduction in tumor size and their tumors disappeared completely more often under neoadjuvant chemotherapy.

Patients with hormone receptor-negative tumors who completed the physical training were significantly more likely to be able to complete the chemotherapy at the planned, optimal dose than patients in the control group. In addition, patients in the training groups were significantly less likely to discontinue chemotherapy prematurely.

Martina Schmidt, Department of Exercise, Prevention Research and Cancer at the DKFZ and NCT Heidelberg, is the first author of the publication on BENEFIT. She says: “Our results underscore that guided strength or endurance training can be helpful even during neoadjuvant chemotherapy.” It is also important to consider tumor and treatment status when evaluating the effectiveness of exercise as a cancer therapy. “To gain further insights into the mechanisms of action and possible modifying factors, we are currently analyzing blood samples from the BENEFIT participants, among other things,” says Martina Schmidt.

Publication:

Martina E. Schmidt, Siri Goldschmidt, Charlotte Kreutz, Jana Müller, Andreas Schneeweiss, Anne M. May, Friederike Rosenberger, Joachim Wiskemann, Karen Steindorf: Effects of aerobic or resistance exercise during neoadjuvant chemotherapy on tumor response and therapy completion in women with breast cancer: The randomized controlled BENEFIT trial, Journal of Sport and Health Science 2025, https://doi.org/10.1016/j.jshs.2025.101064

The NCT is a long-term collaboration between the DKFZ, excellent partners in university medicine, and other outstanding research partners at various locations in Germany.

An image accompanying this press release is available free of charge at:
https://www.nct-heidelberg.de/fileadmin/media/nct-heidelberg/news/pressemitteilungen/BENEFIT_NCT_Heidelberg.jpg

Notice regarding the use of images in press releases
Use is free of charge. The NCT Heidelberg permits one-time use in connection with reporting on the topic of the press release. Please cite the copyright “NCT Heidelberg” as the source. The image material may only be passed on to third parties after prior consultation with NCT Communications (tel.: +49 6221 42-1755, email: martin.staiger(at)nct-heidelberg.de). Use for commercial purposes is prohibited.

Contact for the press:
Dr. Martin Staiger
National Center for Tumor Diseases (NCT) Heidelberg
Communication and Events
Im Neuenheimer Feld 460
69120 Heidelberg
Phone: +49 6221 56-311272
E-mail: martin.staiger(at)nct-heidelberg.de
www.nct-heidelberg.de

The National Center for Tumor Diseases (NCT) Heidelberg
The National Center for Tumor Diseases (NCT) Heidelberg is a joint institution of the German Cancer Research Center (DKFZ), the University Hospital Heidelberg (UKHD), the Heidelberg Medical Faculty of the Heidelberg University and the Thoraxklinik Heidelberg. The aim of the NCT Heidelberg is to transfer promising approaches from cancer research into clinical practice as quickly as possible, and thus to benefit patients. This applies to both diagnosis and treatment, in aftercare or prevention. Participation in clinical studies opens up access to innovative therapies. The NCT Heidelberg is thus a leader in transferring new research results from the laboratory to the clinic The NCT Heidelberg, founded in 2004, is part of the NCT with further locations in Berlin, Dresden, SouthWest (Tübingen-Stuttgart/Ulm), WERA (Würzburg, Erlangen, Regensburg, Augsburg) and West (Essen/Cologne).
 

German Cancer Research Center (DKFZ)
With more than 3,000 employees, the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is Germany’s largest biomedical research institute. DKFZ scientists identify cancer risk factors, investigate how cancer progresses and develop new cancer prevention strategies. They are also developing new methods to diagnose tumors more precisely and treat cancer patients more successfully. The DKFZ's Cancer Information Service (KID) provides patients, interested citizens and experts with individual answers to questions relating to cancer.

To transfer promising approaches from cancer research to the clinic and thus improve the prognosis of cancer patients, the DKFZ cooperates with excellent research institutions and university hospitals throughout Germany:

• National Center for Tumor Diseases (NCT, 6 sites)  
• German Cancer Consortium (DKTK, 8 sites)
• Hopp Children's Cancer Center (KiTZ) Heidelberg
• Helmholtz Institute for Translational Oncology (HI-TRON Mainz) - A Helmholtz Institute of the DKFZ
• DKFZ-Hector Cancer Institute at the University Medical Center Mannheim
• National Cancer Prevention Center (jointly with German Cancer Aid) 

The DKFZ is 90 percent financed by the Federal Ministry of Education and Research and 10 percent by the state of Baden-Württemberg. The DKFZ is a member of the Helmholtz Association of German Research Centers.

Heidelberg University Hospital and Faculty of Medicine: Internationally Renowned Patient Care, Research and Teaching
Heidelberg University Hospital (Universitätsklinikum Heidelberg, UKHD) is one of the largest and most prestigious medical centers in Germany. The Medical Faculty of Heidelberg University (Medizinische Fakultät Heidelberg, MFHD) belongs to the internationally renowned biomedical research institutions in Europe. Both institutions have the common goal of developing new therapies and implementing them rapidly for patients. Heidelberg University Hospital and the Medical Faculty of Heidelberg University employs around 14.500 employees and is committed to providing trainings and qualifications. Every year, around 86,000 patients and more than 1.100.000 outpatient cases are treated in more than 50 clinical departments with almost 2.500 beds.

Together with the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and the German Cancer Aid, the UKHD established the first National Center for Tumor Diseases (NCT) in Heidelberg. The goal is to provide care at the highest level as an oncology center of excellence and to rapidly transfer promising approaches from cancer research to the hospital. In addition, the UKHD operates in partnership with the DKFZ and the University of Heidelberg the Hopp Children’s Cancer center Heidelberg (KiTZ), a unique and nationally known therapy and research center for oncological and hematological diseases in children and adolescents.

The Heidelberg Curriculum Medicinale (HeiCuMed) is one of the top medical training programs in Germany. Currently, there are about 4.000 future physicians studying in Heidelberg.

Researchers at the National Center for Tumor Diseases (NCT) Heidelberg, the German Cancer Research Center (DKFZ), and Heidelberg University Hospital (UKHD) have investigated how physical exercise during chemotherapy affects the course of breast cancer in the BENEFIT study. They concluded that physical training causes tumors to shrink more in patients with certain breast cancer characteristics than in the control group.

The National Center for Tumor Diseases (NCT) Heidelberg is a joint institution of the German Cancer Research Center (DKFZ), Heidelberg University Hospital (UKHD), the Medical Faculty of Heidelberg University, and the Thorax Clinic Heidelberg.

The positive effect of exercise on the physical and mental well-being and quality of life of cancer patients has been proven in many studies. Based on this, researchers at the NCT Heidelberg, the DKFZ, and the UKHD wanted to find out to what extent exercise could also reduce the growth and spread of a tumor or enhance the success of chemotherapy. Research on mice as well as preclinical and epidemiological studies suggest that this effect may exist. However, there have been very few randomized clinical trials with cancer patients to date.

This is where the BENEFIT study comes in, jointly led by Karen Steindorf, Department of Exercise, Prevention Research and Cancer at the DKFZ and NCT Heidelberg, and Joachim Wiskemann, AG Oncological Sports and Exercise Therapy at the UKHD and NCT Heidelberg. In the BENEFIT study, their teams investigated how systematic physical training by breast cancer patients during neoadjuvant chemotherapy, i.e., chemotherapy before surgery, affects the tumor. The study design of BENEFIT offers the opportunity to evaluate success parameters known from drug studies, such as the complete disappearance of the tumor, known as complete remission, or tumor size in the context of the effect of physical training.

In BENEFIT, 180 patients with non-metastatic breast cancer were randomized, i.e., randomly assigned to one of three groups, before starting neoadjuvant chemotherapy. Groups 1 and 2 received an exercise intervention during the chemotherapy period, either guided strength training or endurance training. The third group received strength training after chemotherapy and surgery and served as the control group for the current study. During the course of the study, no adverse complications or events related to training occurred in either the endurance or strength training group, so physical training can also be considered safe during neoadjuvant chemotherapy.

Depending on the characteristics of the breast cancer, the training program had different effects during chemotherapy. When all study participants were considered together, there were therefore no significant effects on tumor size. However, in patients with hormone receptor-positive tumors, the training interventions were associated with a greater reduction in tumor size and their tumors disappeared completely more often under neoadjuvant chemotherapy.

Patients with hormone receptor-negative tumors who completed the physical training were significantly more likely to be able to complete the chemotherapy at the planned, optimal dose than patients in the control group. In addition, patients in the training groups were significantly less likely to discontinue chemotherapy prematurely.

Martina Schmidt, Department of Exercise, Prevention Research and Cancer at the DKFZ and NCT Heidelberg, is the first author of the publication on BENEFIT. She says: “Our results underscore that guided strength or endurance training can be helpful even during neoadjuvant chemotherapy.” It is also important to consider tumor and treatment status when evaluating the effectiveness of exercise as a cancer therapy. “To gain further insights into the mechanisms of action and possible modifying factors, we are currently analyzing blood samples from the BENEFIT participants, among other things,” says Martina Schmidt.

Publication:

Martina E. Schmidt, Siri Goldschmidt, Charlotte Kreutz, Jana Müller, Andreas Schneeweiss, Anne M. May, Friederike Rosenberger, Joachim Wiskemann, Karen Steindorf: Effects of aerobic or resistance exercise during neoadjuvant chemotherapy on tumor response and therapy completion in women with breast cancer: The randomized controlled BENEFIT trial, Journal of Sport and Health Science 2025, https://doi.org/10.1016/j.jshs.2025.101064

The NCT is a long-term collaboration between the DKFZ, excellent partners in university medicine, and other outstanding research partners at various locations in Germany.

An image accompanying this press release is available free of charge at:
https://www.nct-heidelberg.de/fileadmin/media/nct-heidelberg/news/pressemitteilungen/BENEFIT_NCT_Heidelberg.jpg

Notice regarding the use of images in press releases
Use is free of charge. The NCT Heidelberg permits one-time use in connection with reporting on the topic of the press release. Please cite the copyright “NCT Heidelberg” as the source. The image material may only be passed on to third parties after prior consultation with NCT Communications (tel.: +49 6221 42-1755, email: martin.staiger(at)nct-heidelberg.de). Use for commercial purposes is prohibited.

Contact for the press:
Dr. Martin Staiger
National Center for Tumor Diseases (NCT) Heidelberg
Communication and Events
Im Neuenheimer Feld 460
69120 Heidelberg
Phone: +49 6221 56-311272
E-mail: martin.staiger(at)nct-heidelberg.de
www.nct-heidelberg.de

The National Center for Tumor Diseases (NCT) Heidelberg
The National Center for Tumor Diseases (NCT) Heidelberg is a joint institution of the German Cancer Research Center (DKFZ), the University Hospital Heidelberg (UKHD), the Heidelberg Medical Faculty of the Heidelberg University and the Thoraxklinik Heidelberg. The aim of the NCT Heidelberg is to transfer promising approaches from cancer research into clinical practice as quickly as possible, and thus to benefit patients. This applies to both diagnosis and treatment, in aftercare or prevention. Participation in clinical studies opens up access to innovative therapies. The NCT Heidelberg is thus a leader in transferring new research results from the laboratory to the clinic The NCT Heidelberg, founded in 2004, is part of the NCT with further locations in Berlin, Dresden, SouthWest (Tübingen-Stuttgart/Ulm), WERA (Würzburg, Erlangen, Regensburg, Augsburg) and West (Essen/Cologne).
 

German Cancer Research Center (DKFZ)
With more than 3,000 employees, the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is Germany’s largest biomedical research institute. DKFZ scientists identify cancer risk factors, investigate how cancer progresses and develop new cancer prevention strategies. They are also developing new methods to diagnose tumors more precisely and treat cancer patients more successfully. The DKFZ's Cancer Information Service (KID) provides patients, interested citizens and experts with individual answers to questions relating to cancer.

To transfer promising approaches from cancer research to the clinic and thus improve the prognosis of cancer patients, the DKFZ cooperates with excellent research institutions and university hospitals throughout Germany:

• National Center for Tumor Diseases (NCT, 6 sites)  
• German Cancer Consortium (DKTK, 8 sites)
• Hopp Children's Cancer Center (KiTZ) Heidelberg
• Helmholtz Institute for Translational Oncology (HI-TRON Mainz) - A Helmholtz Institute of the DKFZ
• DKFZ-Hector Cancer Institute at the University Medical Center Mannheim
• National Cancer Prevention Center (jointly with German Cancer Aid) 

The DKFZ is 90 percent financed by the Federal Ministry of Education and Research and 10 percent by the state of Baden-Württemberg. The DKFZ is a member of the Helmholtz Association of German Research Centers.

Heidelberg University Hospital and Faculty of Medicine: Internationally Renowned Patient Care, Research and Teaching
Heidelberg University Hospital (Universitätsklinikum Heidelberg, UKHD) is one of the largest and most prestigious medical centers in Germany. The Medical Faculty of Heidelberg University (Medizinische Fakultät Heidelberg, MFHD) belongs to the internationally renowned biomedical research institutions in Europe. Both institutions have the common goal of developing new therapies and implementing them rapidly for patients. Heidelberg University Hospital and the Medical Faculty of Heidelberg University employs around 14.500 employees and is committed to providing trainings and qualifications. Every year, around 86,000 patients and more than 1.100.000 outpatient cases are treated in more than 50 clinical departments with almost 2.500 beds.

Together with the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and the German Cancer Aid, the UKHD established the first National Center for Tumor Diseases (NCT) in Heidelberg. The goal is to provide care at the highest level as an oncology center of excellence and to rapidly transfer promising approaches from cancer research to the hospital. In addition, the UKHD operates in partnership with the DKFZ and the University of Heidelberg the Hopp Children’s Cancer center Heidelberg (KiTZ), a unique and nationally known therapy and research center for oncological and hematological diseases in children and adolescents.

The Heidelberg Curriculum Medicinale (HeiCuMed) is one of the top medical training programs in Germany. Currently, there are about 4.000 future physicians studying in Heidelberg.