Researching the Effect of Aerobic Exercise on Cancer

Inclusion criteria

Cohort 1: CH

• CH called by MSK practices as documented by an MSK physician
• Age ≥18 yrs
• Completion of all anticancer therapy
• High risk of cardiovascular disease defined by presence of at least one of the following:

• Age ≥60
• Prior treatment with chemotherapy
• Prior left-sided breast and/or chest wall radiotherapy
• Currently receiving or previously received androgen deprivation therapy Prior bone marrow transplant
• History of smoking
• Currently treated for one or more cardiovascular risk factors (i.e., hypertension, diabetes, hyperlipidemia)
• Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures

Cohort 2: Solid Tumor

• Patients at risk of harboring circulating tumor DNA as defined by one of the following:

• Histologically confirmed stage III (i.e., high risk of recurrence) colorectal cancer within 2 years of completion of all adjuvant therapy.
• Histologically confirmed stage III breast cancer with residual disease after neoadjuvant therapy and within 12 months of completing (neo)adjuvant chemotherapy
• Patients with metastatic breast cancer and radiographic stable disease or NED for ≥6 months and not currently receiving chemotherapy (endocrine therapy and anti-HER2 antibodies allowed)
• Age ≥ 18 yrs
• Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures

Cohort 3: Active Surveillance

• Men with histologically confirmed localized prostate cancer undergoing active surveillance
• Age ≥ 18 yrs
• Performing less than 15 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures
• Cleared for exercise participation as per pre-screening clearance via PAR-Q+

Cohort 4: Lynch Syndrome

• Age ≥18 yrs
• Hereditary colorectal cancer syndrome, specifically Lynch syndrome, defined by the presence of a deleterious germline mutation in the MLH1, MSH2, MSH6, PMS2 or EPCAM genes
• Have a portion of the distal colon or rectosigmoid intact to enable collection of normal mucosa biopsies
• Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures
• Cleared for exercise participation as per pre-screening clearance via PAR-Q+

Cohort 5: EDD Phase 0a

• Age ≥18 yrs
• Receiving investigational agent under an EDD protocol for at least 2 months.
• Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures
• Cleared for exercise participation as per pre-screening clearance via PAR-Q+

Phase 0b

• Age ≥18 yrs
• Newly Within 3 months of initiating investigational agent on an EDD Service protocol
• Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures
• Cleared for exercise participation as per pre-screening clearance via PAR-Q+

Exclusion criteria

• Concurrent use of any form of antitumor therapy (endocrine therapy and anti-HER2 antibodies allowed)
• Enrollment onto any other interventional investigational study except interventions determined by the PI not to confound study outcomes (does not apply to Cohort 5: EDD)
• Any other condition or intercurrent illness that, in the opinion of the investigator, makes the subject a poor candidate for study participation.
• Mental impairment leading to inability to cooperate
• Any of the following contraindications to cardiopulmonary exercise testing (Cohorts 1 and 2 only):

• 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 pulmonary embolus or pulmonary infarction within 3 months of any planned study procedures
• Thrombosis of lower extremities within 3 months of any planned study procedures
• Suspected dissecting aneurysm
• Uncontrolled asthma
• Pulmonary edema
• Respiratory failure
• Acute non-cardiopulmonary disorders that may affect exercise performance
• Room air desaturation at rest ≤ 85% (Cohorts 1 and 2 only)