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55, 95% CI = - 0.88 to - 0.23, I2 = 0%, P = 0.0009; SMD = - 0.62, 95% CI = - 0.95 to - 0.29, I2 = 0%, P = 0.0002), and decreased levels of sICAM-1. Moderate-intensity exercise was associated with a more pro-inflammatory immune state, resulting in increased oxidative DNA damage. However, no evidence was found for effects of exercise on psychosocial outcomes or body composition. Conclusions Our results revealed that exercise could be a feasible and effective option for improving cardiopulmonary fitness, metabolism, and tumor-related biomar