The purpose of this study is to find out whether an 8-week digital health promotion program called COBRA is a safe and practical (feasible) option for older adults with cancer/OAC.

Inclusion Criteria:

Older Adult Patients with Cancer

- Are within 1 year of completion of primary therapy for cancer OR have a diagnosis of metastatic cancer;

1. For the purpose of this study, primary therapy is defined as treatment of curative intent, first-line or later, from which the individual is advancing to active surveillance or follow-up with or without maintenance therapy.
2. Individuals with metastatic cancer may be included provided they have stable disease or better per most recent restaging exam at time of enrollment.

i. Patients with stable metastatic bony disease at most recent restaging exam and a score of 0-2 on the Functional Pain Scale (FPS69; Appendix 18) are eligible. The PI will consult with the Rehab Med co-PI for FPS scores of 3 or greater, by patient request or PI discretion.

ii. Patients with symptomatic visceral metastases will be evaluated on a case-by-case basis at time of enrollment.

• Are aged 65 years and older, with no upper age limit;
• ECOG PS 0-3 or Karnofsky PS greater than or equal to 40;
• Can read and speak English;
• Self-report access to internet connection sufficient to support videoconferencing.

Clinicians

• Licensed clinician (MD, RN, APP) with an interest in the care of older adults with cancer.

Exclusion Criteria:

Older Adult Patients with Cancer

• Have any cognitive impairment, neurologic, musculoskeletal, or other comorbid condition (as assessed by their provider) that would prevent the individual from engaging with the digital health coaching program or complete study assessments or engage in progressive intensity levels of physical activity
• Have a neurologic, musculoskeletal, or other comorbid condition that would impede their ability to safely engage in progressive intensity levels of physical activity (as assessed by their provider). Patients with metastatic disease and suspected interim progression since last restaging exam will be referred back to their primary oncology care team for evaluation prior to enrollment.
• Have activity restrictions post-surgery at the time of enrollment

Clinicians No expected exclusions

Memorial Sloan Kettering Cancer Center supports the international committee of medical journal editors (ICMJE) and the ethical obligation of responsible sharing of data from clinical trials. The protocol summary, a statistical summary, and informed consent form will be made available on clinicaltrials.gov when required as a condition of Federal awards, other agreements supporting the research and/or as otherwise required. Requests for deidentified individual participant data can be made following one year after publication and for up to 36 months later. Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals. Requests may be made to: crdatashare@mskcc.org.