NEOREHAB

Summary

Curable surgical lung cancer patients are often elderly, current smokers and have medical comorbidities. Since March 2023, a new treatment has been offered involving chemo-immunotherapy before surgery, which has been reported to improve survival. However, 20% of patients are not able to undergo surgery, and others suffer treatment-related side effects.

To maximise the benefits of the neoadjuvant regimen, there is an urgent need to optimise patients’ health before, during and after surgery, to allow the advantages of immunotherapy to be translated into improved survival. Investigating guideline-recommended cardio-pulmonary fitness for surgery in this context is needed as it can identify predictors of fitness decline and surgical complications to select high-risk groups who may benefit most from an exercise programme.

The NEOREHAB study will evaluate the feasibility of providing a hybrid exercise programme for patients undergoing neoadjuvant treatment for resectable lung cancer. We will assess the effect of this intervention on Quality of Life, fitness for surgery, postoperative morbidity and serum inflammatory markers.

What we plan to do

100 adults (18 years or older) referred to neoadjuvant chemo-immunotherapy for lung cancer will be approached for this study. Once consented, these patients will be randomised into the intervention and control arms.

The intervention will start immediately after randomisation and will continue through the neoadjuvant treatment phase, concluding shortly before surgery. A follow-up visit will be conducted six weeks after surgery to collect recovery and Patient Reported Outcome Measures data and to support sustained engagement in healthy behaviours going forwards.