{"entity":{"id":"idea-bio2-protein-plus-training-during-io","kind":"idea","name":"Test protein and resistance training during immunotherapy","aka":[],"tldr":"Muscle is an immune organ as well as a movement organ. Building it during immunotherapy might improve how well the treatment works, not just how patients feel.","summary":"Muscle secretes myokines including interleukin-15 and irisin that affect immune cell function, and low muscle mass is associated with poorer checkpoint inhibitor outcomes in several retrospective series. Whether that association is causal or simply reflects disease burden is unknown, and a randomised exercise and protein intervention during checkpoint therapy would answer it while also improving function.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Cachexia, toxicity and the limits of the patient): Fearon et al., Definition and classification of cancer cachexia (Lancet Oncology 2011)","url":"https://doi.org/10.1016/S1470-2045(10)70218-7"}],"tags":[],"related":["idea-exercise-as-adjuvant"],"cancers":["melanoma","nsclc","rcc"],"sections":[],"technologies":["exercise-oncology","checkpoint-inhibitor"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-cachexia-supportive","b-immunotherapy-response","b-tme-immunosuppression"],"keyPapers":["paper-fearon-lancet-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Supervised resistance training with protein supplementation during checkpoint blockade improves progression-free survival or response rate compared with usual care, mediated by measurable changes in circulating immune cell phenotype.","rationale":"Exercise increases natural killer cell mobilisation and alters myeloid phenotype in humans, and mouse studies show exercise-dependent improvements in tumour immune control. The intervention has no toxicity and independent quality-of-life benefit, so the trial is low-risk.","test":"A randomised trial in patients starting checkpoint blockade with response and immune profiling co-primary endpoints, powered pragmatically and embedded in routine care.","maturity":"speculative","actor":"research","cost":"medium","horizonYears":5},"route":"/ideas/idea-bio2-protein-plus-training-during-io/","neighbours":{"idea":[{"id":"idea-exercise-as-adjuvant","kind":"idea","name":"Structured exercise prescribed like a drug in all curative-intent cancer care","route":"/ideas/idea-exercise-as-adjuvant/"}],"cancer":[{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"rcc","kind":"cancer","name":"Renal cell carcinoma","route":"/cancers/rcc/"}],"technology":[{"id":"exercise-oncology","kind":"technology","name":"Exercise & lifestyle oncology","route":"/technologies/exercise-oncology/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}],"bottleneck":[{"id":"b-cachexia-supportive","kind":"bottleneck","name":"Cachexia, toxicity and the limits of the patient","route":"/bottlenecks/b-cachexia-supportive/"},{"id":"b-tme-immunosuppression","kind":"bottleneck","name":"Cold tumours and the immunosuppressive microenvironment","route":"/bottlenecks/b-tme-immunosuppression/"},{"id":"b-immunotherapy-response","kind":"bottleneck","name":"No one can predict who responds to immunotherapy","route":"/bottlenecks/b-immunotherapy-response/"}],"paper":[{"id":"paper-fearon-lancet-oncol","kind":"paper","name":"Definition and classification of cancer cachexia: an international consensus","route":"/key-papers/paper-fearon-lancet-oncol/"}]}}