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The Impact of Exercise on the Tumor Microenvironment in Patients With Lung Cancer

Sponsored by University of Arizona

About this study

There is increased interest and knowledge about the lung cancer tumor microenvironment (TME). Investigators hypothesize that patients with better baseline physiologic health will have better post-operative outcomes and that strenuous exercise will alter the TME and genetic make-up of the tumor, improving the tumor immune response. Investigators aim to identify the peri-operative and clinical outcomes that differ based on pre-operative VO2max, HRV and resting heart rate following resection of early-stage lung cancer. The physiologic states that are individual and measurable with wearable devices include but are not limited to VO2max, heart rate variability (HRV), and average resting heart rate. Investgators hypothesize that a patient's pre-operative physiologic function with higher VO2max, HRV and lower resting heart rate will be associated with improved peri-operative and post-operative outcomes. Second, investigators will compare alterations in TME based on targeted pre-operative exercise (60-80% of their VO2 max for 75min/week x2 weeks) compared to normal activity adults following resection of early-stage lung cancer. Investigators hypothesize that strenuous exercise in the pre-operative period will impact the TME by increasing levels of cytokines.

Background Lung cancer continues to be the most common cause of cancer related death in both men and women. Patients have variable responses to treatment, whether they receive neoadjuvant therapy or surgery alone. Many of these variations can be attributed to known patient risk factors including age, smoking status, and BMI. However, there are more complex pathophysiologic factors that affect how patients respond and recover from all insults, including cancer. Lung cancer resides in a complex milieu known as the lung tumor microenvironment (TME). The TME includes the cellular makeup of the tumor as well as factors such as IL6, PDL1 ligand, COX2, PGE2, and other cytokines. These factors can cause the TME to change in states of inflammation, such as COPD, and impact carcinogenesis (1-3). T…

Where this study is enrolling

Who can participate

Inclusion criteria

  • ✓lung cancer
  • ✓low risk for submaximal exercise testing in accordance with the risk stratification guidelines published by the American Heart Association and the American College of Sports Medicine (AHA/ACSM criteria).

Exclusion criteria

  • ✕younger than 18 years of age
  • ✕select a condition on the ACSM-AHA pre-exercise screening questionnaire indicating that physician approval is required prior to exercise
  • ✕body mass index of \>30 kg/m2
  • ✕waist girth of \>102cm for men and \>88cm for women
  • ✕have chronic/debilitating arthritis
  • ✕have been bedridden in the past three months
  • ✕have common illness (i.e. colds) within the past 6-weeks
  • ✕hepatitis
  • ✕history of stroke
  • ✕major affective disorder
  • ✕autoimmune disease
  • ✕pregnancy or are breast-feeding
  • ✕history of severe anaphylactic reaction to an allergen
  • ✕present with more than one of the following CVD risk factors: family history of myocardial infarction, coronary revascularization, or sudden death before 55 years of age in father or other male first-degree relative or before 65 years of age in mother or other female first-degree relative

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Trial data sourced from ClinicalTrials.gov.