The Effect of exeRcise And Diet on Quality of Life in Patients With Incurable Cancer of Esophagus and Stomach (RADICES)

Inclusion Criteria:

• Incurable adenocarcinoma of the esophagus or stomach.

• Progressive disease after first-line palliative systemic treatment OR within 6months after completion of curative treatment (i.e. within six months afterneoadjuvant chemoradiation, adjuvant nivolumab, or definitive chemoradiation foresophageal adenocarcinoma or within six months after adjuvant 5-fluorouracil,leucovorin, oxaliplatin and docetaxel (FLOT) for gastric/esophageal cancer orneoadjuvant FLOT if no adjuvant FLOT was given, or after progression duringparticipation in the LyRICX study). Patients on capecitabine monotherapy who areeligible for oxaliplatin reintroduction can be included, too. Inclusion can takeplace regardless of the plan or the actual initiation of multi-line systemictreatment. (i.e. patients that have already started with second/third/etc. linetherapy are eligible for inclusion too)

• Able and willing to perform the exercise and nutritional program and wear theactivity tracker.

• Able and willing to fill out the POCOP/RADICES questionnaires.

• Life expectancy > 12 weeks.

• Age ≥ 18 years.

Exclusion Criteria:

• Unstable bone metastases inducing skeletal fragility as determined by the treatingclinician.

• Untreated symptomatic known brain metastasis.

• Serious active infection.

• Too physically active (i.e. >210 minutes/week of moderate-to-vigorous intentionalexercise) or engaging in intense exercise training comparable to the RADICESexercise program.

• Severe neurologic or cardiac impairment according to the American College of SportsMedicine criteria.

• Uncontrolled severe respiratory insufficiency as determined by the treatingclinician or if the patient is dependent on oxygen suppletion in rest or duringexercise.

• Uncontrolled severe pain.

• Any other contraindications for exercise as determined by the treating physician.

• Any circumstances that would impede adherence to study requirements or ability togive informed consent, as determined by the treating clinician.

• Pregnancy.