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Home Respiratory Rehabilitation in Patients With Lung Cancer Non-small Cell Advanced or Metastatic Treated With Oral Targeted Therapy

The feasibility and impact of respiratory rehabilitation (RR) in patients with advanced or metastatic (EGF-R WT or mutated) non-small cell lung cancer treated with oral targeted therapy including Inhibitors of EGF-R tyrosine kinases (TKI) and ALK inhibitors.

These patients will benefit, at the beginning of the chemotherapy whatever the treatment line, of a respiratory rehabilitation. The respiratory rehabilitation takes place at the patient's home with the HAD's cooperation 3 hours per week, divided into 2 or 3 sessions. There is associated educational, nutritional and psychological support for a total duration of 8 weeks.

Inclusion Criteria:

• Patient with advanced or metastatic lung cancer
• In the course of treatment by oral chemotherapy of oral targeted therapy (tyrosine kinase inhibitor) in 1st, 2nd, 3rd line or more at the time of their inclusion
• Diagnosis of CP retained after multidisciplinary discussion of patient records

Exclusion Criteria:

• Any residual toxicity of a previous antineoplastic treatment, grade> 2.
• Cardio-respiratory contraindications to exercise re-training:
• Angina unstable
• Recent infarct
• Tight aortic stenosis
• Unsteady heart failure
• Pericarditis, endocarditis, myocarditis
• Evolutionary thromboembolic disease
• Ventricular aneurysm
• Intra ventricular thrombus
• Uncontrolled rhythm disorders
• Instability of the respiratory state defined by uncompensated respiratory acidosis
• Carcinological contraindications:
• Bone metastases at risk of fracture and / or algae despite optimal analgesic treatment, symptomatic central nervous system metastases
• Presence of anemia (Hb <8g / dl or <10g / dl if patient with previous cardiac history), thrombocytopenia (<100,000 platelets / mm3)
• Chimio toxicity (neurological, cardiac) according to the investigator's assessment
• Neuromuscular contraindications:
• Neuromuscular and / or osteo-articular disease making it impossible to re-train
• Severe cognitive impairment
• Patient under tutorship or curatorship