{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T01:05:56Z","timestamp":1783991156259,"version":"3.55.0"},"reference-count":235,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["Ricerca Corrente 2027"],"award-info":[{"award-number":["Ricerca Corrente 2027"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Over the last few decades, survival among patients with lung cancer (LC) has progressively improved due to major advances in treatment strategies, particularly the introduction of immunotherapy and targeted therapies, as well as the increased detection of early-stage disease resulting from the widespread use of chest computed tomography (CT). Although the reduction in mortality, frequently achieved through effective control of the primary disease, represents a major therapeutic success, it also raises new clinical challenges, including the long-term management of cancer remission or disease stability and the competing risk of adverse outcomes related to comorbidities and treatment-related toxicities. Among these, cardiovascular (CV) complications have emerged as particularly relevant because of their frequency and prognostic impact. Within the framework of a holistic long-term management approach, increasing attention should be directed toward non-pharmacological interventions targeting lifestyle factors, particularly nutrition and physical exercise, whose role remains underestimated. These interventions may modulate chronic inflammation and immune responses, which are key drivers influencing both the effectiveness of novel anticancer therapies and the progression of cardiovascular complications. Patients with LC frequently present malnutrition and unfavorable lifestyle patterns associated with substantial physical and psychological stress, factors that may negatively affect treatment outcomes and overall prognosis. This narrative review examines the emerging role of targeted nutritional strategies and structured physical exercise as integral components of supportive care in LC, with a specific focus on their impact on cardiac metabolism, CV risk, and response to anticancer therapies, including immunotherapy.<\/jats:p>","DOI":"10.3390\/nu18142290","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:55:21Z","timestamp":1783990521000},"page":"2290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Nutrition and Exercise to Mitigate Cardiometabolic Risk and Enhance Outcomes in Lung Cancer During the Era of Immunotherapy and Targeted Therapy"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9835-2674","authenticated-orcid":false,"given":"Giuseppina","family":"Gallucci","sequence":"first","affiliation":[{"name":"Independent Researcher, 85025 Melfi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6331-6908","authenticated-orcid":false,"given":"Alessandro","family":"Inno","sequence":"additional","affiliation":[{"name":"Medical Oncology, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6435-9504","authenticated-orcid":false,"given":"Stefania","family":"Fugazzaro","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Costi","sequence":"additional","affiliation":[{"name":"Research and EBP Unit, Health Professions Department, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"},{"name":"Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Di","family":"Leo","sequence":"additional","affiliation":[{"name":"Psycho-Oncology Unit, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora","family":"Pezzuolo","sequence":"additional","affiliation":[{"name":"Medicina Oncologica, Ospedale di Guastalla e Correggio, Area Nord, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Zanelli","sequence":"additional","affiliation":[{"name":"Provincial Medical Oncology, Department of Oncology and Advanced Technologies, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Ciammella","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8417-7783","authenticated-orcid":false,"given":"Alessandro","family":"Navazio","sequence":"additional","affiliation":[{"name":"Cardioncology Clinic\u2014Cardiologia Ospedaliera, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3159-5268","authenticated-orcid":false,"given":"Carmine","family":"Pinto","sequence":"additional","affiliation":[{"name":"Provincial Medical Oncology, Department of Oncology and Advanced Technologies, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2580-0963","authenticated-orcid":false,"given":"Luigi","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Cardioncology Clinic\u2014Cardiologia Ospedaliera, Azienda Unit\u00e0 Sanitaria Locale (AUSL)-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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