Feasibility and preliminary efficacy of a multimodal exercise, nutrition, and palliative care intervention in advanced lung cancer

Introduction: Advanced lung cancer patients face significant physical and psychological burden leading to reduced quality of life. Physical activity, nutrition, and palliative care interventions may enhance quality of life, however no study has combined these modalities in a multimodal intervention. Therefore, we assessed the feasibility and preliminary efficacy of an exercise, nutrition, and palliative symptom management intervention to improve quality of life in advanced lung cancer. Methods: Participants received an individually-tailored 12-week intervention featuring in-person group-based exercise classes, at-home physical activity prescription, and nutritional and palliative care consults. Patients reported symptom burden and quality of life pre-/post-class, as well as pre-/post-intervention, along with self-reported physical activity and a physical function assessment. Post-intervention interviews examined participant perspectives. Results: The multimodal program was feasible, with 44% recruitment, 75% class attendance, 89% nutrition and palliative consult attendance, and 85% assessment completion. Participants perceived the intervention as feasible and valuable. Physical activity, symptom burden, and quality of life were maintained, while tiredness decreased significantly. Exercise classes prompted acute clinically meaningful reductions in fatigue, tiredness, depression, pain, and increases in energy and well-being. Conclusion: A multimodal exercise, nutrition, and palliative symptom management intervention is feasible and shows potential benefits on quality of life that warrant further investigation.