Impact of intensity, duration and type of acute and chronic exercise on the immune response in lung cancer – application of the FITTT-principle

Exercise and leisure time physical activity (LTPA) have been proven to ameliorate overall health and prognosis in cancer patients. When considering exercise as a complementary treatment strategy for cancer patients, the FITTT principle (frequency, intensity, time, type and timing of exercise) has to be carefully considered. While lots of research has been done on the beneficial effects of a generally active lifestyle, and improved outcomes of individuals with higher physical capacity (as measured by VO2max), novel data highlights the importance of every single exercise bout. Even in untrained patients, every exercise session has defined immune-stimulatory effects, possibly working synergistically along with antitumor immune response and cancer immunotherapy. In this review of the literature, we summarize the existing data on training therapy in cancer patients with a focus on high intensity interval training (HIIT) and application of the FITTT principle. A study from our group (Trial registration: NCT07267000) is about to investigate two exercise regimens in lung cancer patients, with one group performing continuous moderate intensity, versus the other group doing high-intensity interval exercise. The reviewed data highlights the importance of structured training therapy as an integral part of cancer treatment.