A 55-year-old female patient affected by an EGFR mutant NSCLC with multiple lytic bone metastases and two prior pathological fractures, undergoing treatment with osimertinib and denosumab, participated in a 9-month physical exercise program. The exercise program was performed twice a week and consisted of aerobic and strength training. Aerobic training was composed of moderate-intensity continuous training for the first 3 months and then high-intensity interval training. Strength training was performed through body-weight/elastic band exercises for the first 6 months and isotonic machines from months 6-9. Assessments, performed every 3 months, included physical fitness parameters, such as functional capacity, muscle strength, anthropometric measures, body composition, and quality of life. Functional capacity progressively improved by 80 m at month 6 and slightly decreased by 22 m at month 9. At the end of the intervention, grip strength increased in both arms, whereas the body composition showed a progressive decrease in fat mass (-3.39 kg) and an increase in muscle mass (+3.89 kg) until month 6 and then stabilization. Quality of life exhibits a great improvement in the first 3 months, especially in the physical role, emotional functioning, fatigue, pain, dyspnoea, insomnia, appetite loss, constipation, and diarrhea, and then maintained with little variations. This case suggests that a highly structured physical exercise program may be feasible, safe, and effective in patients with lung cancer and bone metastases if performed under the supervision of trained experts.

Combining a 9-month tailored physical exercise program with osimertinib and denosumab in a patient affected by advanced NSCLC with multiple osteolytic bone lesions: A case report

Borsati, Anita;Ciurnelli, Christian;Belluomini, Lorenzo;Sposito, Marco;Insolda, Jessica;Toniolo, Linda;Milella, Michele;Schena, Federico;Pilotto, Sara
;
Avancini, Alice
2025-01-01

Abstract

A 55-year-old female patient affected by an EGFR mutant NSCLC with multiple lytic bone metastases and two prior pathological fractures, undergoing treatment with osimertinib and denosumab, participated in a 9-month physical exercise program. The exercise program was performed twice a week and consisted of aerobic and strength training. Aerobic training was composed of moderate-intensity continuous training for the first 3 months and then high-intensity interval training. Strength training was performed through body-weight/elastic band exercises for the first 6 months and isotonic machines from months 6-9. Assessments, performed every 3 months, included physical fitness parameters, such as functional capacity, muscle strength, anthropometric measures, body composition, and quality of life. Functional capacity progressively improved by 80 m at month 6 and slightly decreased by 22 m at month 9. At the end of the intervention, grip strength increased in both arms, whereas the body composition showed a progressive decrease in fat mass (-3.39 kg) and an increase in muscle mass (+3.89 kg) until month 6 and then stabilization. Quality of life exhibits a great improvement in the first 3 months, especially in the physical role, emotional functioning, fatigue, pain, dyspnoea, insomnia, appetite loss, constipation, and diarrhea, and then maintained with little variations. This case suggests that a highly structured physical exercise program may be feasible, safe, and effective in patients with lung cancer and bone metastases if performed under the supervision of trained experts.
2025
Bone metastasis
Bone-targeted agents
Lung cancer
Physical activity
Safety
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1157214
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