Lung Cancer Exercise Training Study

Inclusion Criteria: * Signed informed consent prior to initiation of study-related procedures * Age 21 - 80 years * Weight \< 205 kgs * ECOG ≤ 1 * Diagnosed with histologically confirmed lung cancer, regardless of disease stage and receiving any prior line of any therapy in the context of metastatic disease * An interval of at least three months following the completion of primary resection, if appropriate * An interval of no longer than ten years following completion of primary therapy, if appropriate * Life expectancy ≥ 4 months * Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week * Exercise intolerance (i.e., patients must have a VO2peak below that predicted for active age and sex-matched individuals) * Willing to be randomized to one of the study arms * Willing to commit to the study program and comply with all related protocol procedures * Able to achieve an acceptable peak baseline CPET, as defined by any of the following criteria: * achieving a plateau in oxygen consumption, concurrent with an increase in power output; * a respiratory exchange ratio ≥ 1.10; * attainment of maximal predicted heart rate (HRmax) (i.e., within 10 bpm of age-predicted HRmax \[HRmax = 220-Age\[years\]); * volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale. * Able to complete an acceptable baseline CPET in the absence of high risk ECG findings or other inappropriate response to exercise as determined by the PI. * Ability to achieve and complete an acceptable baseline one-repetition maximum muscular strength test as defined by the effective execution of protocol-specific joint and muscle ranges of motion without remarkable signs or symptoms of pain, discomfort or distress. Exclusion Criteria: * Presence of a concurrent, actively treated other malignancy, or history of other malignancy treated within the past 3 years (other than non-melanoma skin cancer); * Room air desaturation at rest ≤ 85%; * Mental impairment leading to inability to cooperate. * Any of the following absolute contraindications to cardiopulmonary exercise testing: * Acute myocardial infarction (within 3-5 days of any planned study procedures); * Unstable angina; * Uncontrolled arrhythmia causing symptoms or hemodynamic compromise; * Recurrent syncope; * Active endocarditis; * Acute myocarditis or pericarditis; * Symptomatic severe aortic stenosis; * Uncontrolled heart failure; * Acute (within 3 months) pulmonary embolus or pulmonary infarction; * Thrombosis of lower extremities; * Suspected dissecting aneurysm; * Uncontrolled asthma; * Pulmonary edema; * Respiratory failure; * Acute non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis)