Lung Cancer Exercise Training Study

Inclusion Criteria:

Signed informed consent prior to initiation of study-related procedures
Age 21 - 80 years
Weight < 205 kgs
ECOG ≤ 1
Diagnosed with histologically confirmed lung cancer, regardless of disease stage and receiving any prior line of any therapy in the context of metastatic disease
An interval of at least three months following the completion of primary resection, if appropriate
An interval of no longer than ten years following completion of primary therapy, if appropriate
Life expectancy ≥ 4 months
Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week
Exercise intolerance (i.e., patients must have a VO2peak below that predicted for active age and sex-matched individuals)
Willing to be randomized to one of the study arms
Willing to commit to the study program and comply with all related protocol procedures

Able to achieve an acceptable peak baseline CPET, as defined by any of the following criteria:

achieving a plateau in oxygen consumption, concurrent with an increase in power output;
a respiratory exchange ratio ≥ 1.10;
attainment of maximal predicted heart rate (HRmax) (i.e., within 10 bpm of age-predicted HRmax [HRmax = 220-Age[years]);
volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale.
Able to complete an acceptable baseline CPET in the absence of high risk ECG findings or other inappropriate response to exercise as determined by the PI.
Ability to achieve and complete an acceptable baseline one-repetition maximum muscular strength test as defined by the effective execution of protocol-specific joint and muscle ranges of motion without remarkable signs or symptoms of pain, discomfort or distress.

Exclusion Criteria:

Presence of a concurrent, actively treated other malignancy, or history of other malignancy treated within the past 3 years (other than non-melanoma skin cancer);
Room air desaturation at rest ≤ 85%;
Mental impairment leading to inability to cooperate.

Any of the following absolute contraindications to cardiopulmonary exercise testing:

Acute myocardial infarction (within 3-5 days of any planned study procedures);
Unstable angina;
Uncontrolled arrhythmia causing symptoms or hemodynamic compromise;
Recurrent syncope;
Active endocarditis;
Acute myocarditis or pericarditis;
Symptomatic severe aortic stenosis;
Uncontrolled heart failure;
Acute (within 3 months) pulmonary embolus or pulmonary infarction;
Thrombosis of lower extremities;
Suspected dissecting aneurysm;
Uncontrolled asthma;
Pulmonary edema;
Respiratory failure;
Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis); or