Combined Aerobic and Resistance Exercise Training in Metastatic Renal Cell Carcinoma

Inclusion Criteria:

Histologically confirmed diagnosis of RCC
Patients being treated with standard of Programmed cell death protein 1 (anti-PD-1) or anti-PD-L1 immune-checkpoint inhibitor-containing standard of care regimen including patients who are about to start treatment or have been on treatment for a maximum of 4 weeks prior to signing consent
Metastatic Measurable disease, as defined by RECIST 1.1
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 with a life expectancy ≥ six months
Physically able to enroll in the exercise program as determined by the treating medical oncologist and after review by Physical medicine and rehabilitation physicians at Johns Hopkins
Adequate bone marrow reserve and organ function measured within 28 days prior to administration of study treatment with the following key parameters:

Hematological:

Absolute neutrophil count ≥ 1.5 × 109/L
Platelets ≥ 100 × 109/L
Hemoglobin≥ 9.0 g/dL

Renal:

Serum Creatinine ≤ 1.5 x the upper limit of normal (ULN) or Calculated Creatinine clearance ≥ 30mL/min

Hepatic:

Total bilirubin ≤ 1.5 x ULN (Patients with known Gilbert disease who have serum bilirubin level ≤ 3 x ULN may be enrolled)
Serum Aspartate aminotransferase (AST) and serum Alanine aminotransferase (ALT) ≤ 2.5 x ULN (For patients with documented liver metastases AST and/or ALT ≤ 5 x ULN)

Exclusion Criteria:

The presence of bone metastasis in the spine, pelvis, and lower limbs
Currently physically active or moderately active as determined by Leisure Score Index of Godin Leisure-Time Exercise Questionnaire (GSLTPAQ)
History of underlying cardiovascular, respiratory, musculoskeletal disease or joint problems that preclude moderate physical activity
Known underlying uncontrolled brain metastatic lesions requires steroids therapy and/or radiotherapy
Major surgery within four weeks prior to enrollment.
Radiotherapy for RCC 28 days prior to week 1 day 1