Although exercise training has shown benefits in adult as well as childhood cancer patients during and after cancer treatment, no international common standards for the implementation of paediatric exercise oncology have been established so far. Furthermore, only a few hospitals offer exercise programs as an optional add-on to the standard of care. To date, there are no multicentre randomised controlled clinical trials investigating paediatric exercise oncology during intensive cancer therapy. With FORTEe, the scientific basis for optimizing exercise interventions and its establishment as a routine treatment will be provided. The FORTEe consortium will pool their knowledge and expertise in order to create a vast amount of data to demonstrate that “exercise is medicine” and should be an integral part of clinical practice. In future, paediatric exercise oncology should be considered as a viable enrichment alongside the already established supportive treatments in cancer.
Moreover, precision exercise therapy is a personalised, but simultaneously highly-standardised treatment concept and thus comparable to drug therapies. Analogous to the correct choice and dosage of a pharmaceutical agent (e.g. antiemetics, analgetics, etc.), the exercise type and training load have to be individually adapted to the patient’s condition and needs. Prescribing exercise like a “pill” in the right “dosage”, might become a highly effective instrument in childhood cancer care for the prevention, treatment and management of the acute side-effects of cancer treatment and its sequelae. Moreover, FORTEe develops adapted exercise technology supporting the digital transformation of health and care. Using digital tools and applications, FORTEe has started to elaborate common standards that enable exercise training in the patient's home during cancer treatment and during isolation or physical distancing measurements. Consequently, results will be transferrable to further populations and not only childhood cancer patients could benefit from the results of the FORTEe trial, but also patients suffering from other non-communicable diseases or chronic (paediatric) health conditions such as asthma, diabetes mellitus, obesity, congenital heart disease etc. FORTEe will provide a basis for the development of clinical practice guidelines in paediatric exercise oncology. The establishment of a comprehensive and standardised exercise therapy for childhood cancer patients all over Europe would be an essential step towards improving and equalizing the standards in patient care and a breakthrough for all children suffering from cancer.
