Trial closure: CO21 CHALLENGE

CCTG CO21 CHALLENGE was a phase III randomized trial of the impact of a physical activity program on disease-free survival in patients with stage III or high-risk stage II colon cancer. Researchers have demonstrated that a structured exercise program significantly improves survival for colon cancer patients by reducing the risk of disease recurrence and new primary cancers. The CO21 CHALLENGE trial results were presented at the American Society of Clinical Oncology (ASCO) 2025 annual meeting to a standing ovation and simultaneously published in the New England Journal of Medicine. 

Patients in the exercise program met with the exercise specialist once every two weeks to monitor progress for the first year and then monthly for two more years. The goal was to help them add 2.5 hours of aerobic exercise per week to their usual activity levels and sustain this amount of physical activity for 3 years. After eight years, overall survival was 90% in the structured exercise program and 83% in the health education materials group. Patients in the structured exercise program had a 37% lower risk of death than patients who only received health education materials. 

Courneya, Kerry S.; Vardy, Janette L.; O¿Callaghan, Christopher J.; Gill, Sharlene; Friedenreich, Christine M.; Wong, Rebecca K.S.; Dhillon, Haryana M.; Coyle, Victoria; Chua, Neil S.; Jonker, Derek J.; Beale, Philip J.; Haider, Kamal; Tang, Patricia A.; Bonaventura, Tony; Wong, Ralph; Lim, Howard J.; Burge, Matthew E.; Hubay, Stacey; Sanatani, Michael; Campbell, Kristin L.; Arthuso, Fernanda Z.; Turner, Jane; Meyer, Ralph M.; Brundage, Michael; O¿Brien, Patti; Tu, Dongsheng; Booth, Christopher M.; 
Structured Exercise after Adjuvant Chemotherapy for Colon CancerNew England Journal of Medicine
New England Journal of Medicine:393(1):13 -25,2025