• number of patients with variant allele frequency (VAF) [ Time Frame: 2 years ]
  measured by targeted CH panel in peripheral blood
• changes in residual tumor burden (Solid tumor group) [ Time Frame: 2 years ]
  measured by the amount of circulating tumor DNA (ctDNA)

• Behavioral: exercise (walking)
  Exercise treatment will consist of individualized walking delivered up to 5 times weekly. This trial will evaluate one dose of exercise (i.e., ~300 mins/wk following a non-linear dosing schedule) in both cohorts. Patients will have the option to receive exercise treatment at MSK or at their residence. Home-based exercise will be implemented and monitored using a telemedicine approach (i.e.,TeleEx) established in the Exercise-Oncology (ExOnc) Service
• Other: plasma samples
  Plasma samples will be obtained at baseline.
• Other: blood draw
  fasting blood

• Experimental: patients with clonal hematopoiesis
  Exercise treatment will consist of individualized walking delivered up to 5 times weekly. Patients in all cohorts will receive one dose of exercise (i.e., ~300 mins/wk following a non-linear dosing schedule) in both cohorts. Patients will have the option to receive exercise treatment at MSK or at their residence. Home-based exercise will be implemented and monitored using a telemedicine approach (i.e.,TeleEx) established in the Exercise-Oncology (ExOnc) Service
  Interventions:

  • Behavioral: exercise (walking)
  • Other: blood draw
• Experimental: post treatment patients with breast or colorectal cancer
  Exercise treatment will consist of individualized walking delivered up to 5 times weekly. Patients in all cohorts will receive one dose of exercise (i.e., ~300 mins/wk following a non-linear dosing schedule) in both cohorts. Patients will have the option to receive exercise treatment at MSK or at their residence. Home-based exercise will be implemented and monitored using a telemedicine approach (i.e.,TeleEx) established in the Exercise-Oncology (ExOnc) Service
  Interventions:

  • Behavioral: exercise (walking)
  • Other: plasma samples
  • Other: blood draw
• Experimental: men with localized prostate cancer undergoing active surveillance
  Exercise treatment will consist of individualized walking delivered up to 5 times weekly. Patients in all cohorts will receive one dose of exercise (i.e., ~300 mins/wk following a non-linear dosing schedule) in both cohorts. Patients will have the option to receive exercise treatment at MSK or at their residence. Home-based exercise will be implemented and monitored using a telemedicine approach (i.e.,TeleEx) established in the Exercise-Oncology (ExOnc) Service
  Interventions:

  • Behavioral: exercise (walking)
  • Other: plasma samples
  • Other: blood draw

Inclusion Criteria:

Cohort 1: CH

• CH called by MSK practices as documented by an MSK physician
• Age ≥18 yrs
• Completion of all anticancer therapy

• High risk of cardiovascular disease defined by presence of at least one of the following:

  • Age ≥60
  • Prior treatment with chemotherapy
  • Prior left-sided breast and/or chest wall radiotherapy
  • Currently receiving or previously received androgen deprivation therapy Prior bone marrow transplant
  • History of smoking
  • Currently treated for one or more cardiovascular risk factors (i.e., hypertension, diabetes, hyperlipidemia)
• Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures

Cohort 2: Solid Tumor

• Patients at risk of harboring circulating tumor DNA as defined by one of the following:

  • Histologically confirmed stage III (i.e., high risk of recurrence) colorectal cancer within 2 years of completion of all adjuvant therapy.
  • Histologically confirmed stage III breast cancer with residual disease after neoadjuvant therapy and within 12 months of completing (neo)adjuvant chemotherapy
  • Patients with metastatic breast cancer and radiographic stable disease or NED for ≥6 months and not currently receiving chemotherapy (endocrine therapy and anti-HER2 antibodies allowed)
• Age ≥ 18 yrs
• Performing less than 150 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures

Cohort 3: Active Surveillance

• Men with histologically confirmed localized prostate cancer undergoing active surveillance
• Age ≥ 18 yrs
• Performing less than 30 minutes of structured moderate-intensity or strenuous-intensity exercise per week, as evaluated by self-report
• Willingness to comply with all study-related procedures
• Cleared for exercise participation as per screening clearance via PAR-Q+

Exclusion Criteria:

• Concurrent use of any form of antitumor therapy (endocrine therapy and anti-HER2 antibodies allowed)
• Enrollment onto any other interventional investigational study
• Any other current diagnosis of invasive cancer or hematologic cancer of any kind
• Any other condition or intercurrent illness that, in the opinion of the investigator, makes the subject a poor candidate for study participation.
• Mental impairment leading to inability to cooperate

• Any of the following contraindications to cardiopulmonary exercise testing (Cohorts 1 and 2 only):

  1. Acute myocardial infarction within 3-5 days of any planned study procedures;
  2. Unstable angina
  3. Uncontrolled arrhythmia causing symptoms or hemodynamic compromise
  4. Recurrent syncope
  5. Active endocarditis
  6. Acute myocarditis or pericarditis
  7. Symptomatic severe aortic stenosis
  8. Uncontrolled heart failure
  9. Acute pulmonary embolus or pulmonary infarction within 3 months of any planned study procedures
  10. Thrombosis of lower extremities within 3 months of any planned study procedures
  11. Suspected dissecting aneurysm
  12. Uncontrolled asthma
  13. Pulmonary edema
  14. Respiratory failure
  15. Acute non-cardiopulmonary disorders that may affect exercise performance
• Room air desaturation at rest ≤ 85% (Cohorts 1 and 2 only)