EXERCISE AND RESPONSE TO IMMUNOTHERAPY IN LUNG CANCER

This research project aims at investigating a possible connection between a medically supervised training regimen and the response to immunotherapy in lung cancer patients. Lung cancer is the number one fatal cancer diagnosis worldwide. A few decades ago, the prognosis at lung cancer first diagnosis was generally poor with only a few months of median survival. New immunotherapy treatment regimens have markedly improved survival times especially in certain histologic and molecular pathologic subtypes. The positive effect of exercise on the incidence of several cancer entities such as colorectal- or breast cancer, has been demonstrated previously. Physically active individuals are diagnosed with cancer significantly less often as compared to sedentary people. In oncologic follow-up care, a positive effect of exercise and training with an advantage in survival has also been proven, e.g. in breast cancer patients. In addition, existing data shows a positive effect of exercise on the immune system: active individuals show a different pattern of proinflammatory markers in the blood serum, with every exercise session generating an immune-stimulatory effect which changes the immunologic serum profile also at rest. Thus, regular exercise has an anti-inflammatory long-term effect. With our project we seek to demonstrate a possible benefit on immunotherapy response upon a medically guided training regimen. To exactly define exercise in this setting, as a first step we will test two exercise types in healthy individuals. According to their individual exercise capacity as determined by spiroergometry, healthy subjects will either perform low-intensity continuous exercise (LICE), or a high-intensity interval training (HIIT). By means of venous blood sampling before and after training we shall determine the respective changes of serum immune markers through exercise. The same two training types will then be performed by lung cancer patients upon immunotherapy, with one patient group doing LICE-sessions, one group doing the HIIT and a third group who will stay inactive. Response to therapy and inflammatory serum parameters will be compared between the groups. Exercising patients will be advised to train once a week under medical supervision, and to walk briskly for 30 minutes every day of the week in addition. Our hypothesis is, that exercise should be implemented as a complementary treatment strategy in every oncologic therapy setting, possibly improving not only physical health and wellbeing but also treatment response.