In-Bedroom Renewed Air as Anti-inflammatory Adjuvant Therapy in Cancer Survivors

Inclusion Criteria:

* Adult-onset cancer survivors with a diagnosis of breast, colon, colorectum, rectum, prostate, non-small lung, Hodgkin lymphoma, non-Hodgkin lymphoma, chronic lymphoid leukaemia and chronic myeloid leukaemia cancer.
* Aged ≥ 18 years at cancer diagnosis -upper age limit to study entry = 75 years.
* People of both genders, all racial and ethnic backgrounds.
* Non-smokers (i.e., not smoking during previous 12 months).
* A history of local, regional or distant recurrence, primary second cancers or multiple primary tumours will be not reasons to exclude.
* No previous evidence for metastatic disease.
* Evidence of complete remission defined as a decrease in or disappearance of signs and symptoms of cancer after treatment.
* Having completed definitive treatment (surgery, neoadjuvant/adjuvant cytotoxic chemotherapy, radiotherapy, immunotherapy) at least 12 months.
* Continuous, maintenance therapy is considered if initiated ≥3 months prior to study treatment and prescribed for long-term, chronic use without interruption during the trial, or completed for at least ≥3 months before starting the trial.
* Having a high inflammatory cardiac risk profile at the initial screening defined as a CRP measurement ≥ 3 to \< 10 mg/L, or ≥ 10 mg/L if acute inflammation is ruled out.
* Having stable hypertension (if applicable): no medication changes in prior 30 days, systolic BP \<160 mm Hg and either ≥ 130 mm Hg without antihypertensive medications, or diagnosis of hypertension in medical records.
* Clinical evidence of cardiovascular, respiratory and/or musculoskeletal disease, and/or other controlled and stable chronic medical conditions will not be reason of exclusion.
* Any medical prescription(s) if routinely administered and continued through the trial period.
* Living at one of the urban areas of the city of Valencia with the highest index impact of pollutant on population values (IIPP \> 125): Russafa, Malilla and Arrancapins neighbourhoods.
* Permanent residence in their usual home at least 3 months prior to the first collected blood sample in the first cycle and without plans to move out toward another dwelling during the trial study.
* Living in a non-smoking household.
* Internet connection (Wi-Fi) in the house.
* Signed informed consent prior to commencement of specific protocol procedures.

Exclusion Criteria:

* Recently diagnosed with cancer or plans for additional cancer therapy and/or surgery during the trial period.
* Metastatic disease.
* Planned medication prescription to start during the trial.
* Current chronic anti-inflammatory drug prescriptions or other chronic drugs (e.g., antihypertensive drugs) will be no reason for exclusion if its use is continued for the duration of the trial period.
* Having uncontrolled hypertension: participants with average systolic BP \>160 mmHg over any 10-day period prior and during the study.
* History of uncontrolled, unstable chronic disease as defined by clinical practice guidelines and documented in medical records - within past 6 months to screening visit(s) and during the study (i.e., uncontrolled diabetes mellitus). Psychiatric illness that would limit compliance with trial requirements and/or prevent the patient from giving informed consent.
* History of ongoing, chronic or recurrent infectious disease, and having suspected or proven immunocompromised state (i.e., Human Immunodeficiency Virus infection).
* Self-report of alcohol or substance abuse within the past 12 months, including at-risk drinking (current consumption of more than 14 alcoholic drinks per week).
* Shift workers or subjects who have the work schedule falling outside the hours of 07:00 a.m. and 10:00 p.m.
* Plans to move out of usual home during the trial period.
* Unwilling to spend at least 7-h/overnight in the bedroom.
* Pre-existing an air filtration system that improve household air quality. If so, the device will be disconnected during all the trial cycles.
* Unwilling to give consent.

Additional inclusion criteria (non-exclusive; when CRP test is unavailable in medical records) associated with high or very high cardiovascular (CV) toxicity risk factors (according to the European Society of Cardiology guidelines on Cardio-Oncology):

1. High or very high baseline CV toxicity risk pre-treatment (HFA-ICOS risk stratification score); risk factors including:

   * Prior history of CV disease (e.g., coronary artery disease).
   * Presence of multiple CV-risk factors (e.g., hypertension, dyslipidemia).
   * Current or concomitant cancer treatment.
   * Prior cardiotoxic cancer therapy (e.g., anthracycline, radiotherapy to left chest).
   * Lifestyle risk factors (history of smoking, body mass index \>30).
2. Specific cardiotoxic cancer therapies with a high risk of long-term CV complications (any of these):

   * Total lifetime cumulative dose anthracycline ≥ 250 mg/m2 doxorubicin equivalent.
   * High-dose anthracycline ≥ 250 mg/m2 doxorubicin equivalent.
   * High-dose RT \> 15 Gray (Gy) Mean Heart Dose (MHD).
   * Anthracycline ≥ 100 mg/m2 doxorubicin equivalent in combination with radiotherapy 5-15 Gy MHD.
   * Multitargeted tyrosine kinase inhibitors (TKI) targeting BCR-ABL and concomitant high-dose dexamethasone therapy \>160 mg/month.
   * Combination of RAF and MEK inhibition.
   * Single-agent immune checkpoints inhibitors (ICI) therapy followed by previous cardiotoxic cancer therapies: RT, anthracyclines, 5-fluorouracil, and TKI.
   * Combination of two types of ICI (anti-PD1, e.g., nivolumab and anti-CTLA-4, e.g., ipilimumab).
3. Moderate or severe cancer therapy-related CV toxicity detected during cancer treatment or new CV symptomatic/asymptomatic abnormalities at the end of cancer treatment (3 or 12 months after therapy).