Chemotherapy-induced peripheral neuropathy research: A National Institute of Health (NIH) grant portfolio analysis.

person Rachel D. Altshuler National Cancer Institute, Rockville, MD info_outline Rachel D. Altshuler, Lori M. Minasian, Catherine Schweppe, Nina S. Kadan-Lottick

Authors person Rachel D. Altshuler National Cancer Institute, Rockville, MD info_outline Rachel D. Altshuler, Lori M. Minasian, Catherine Schweppe, Nina S. Kadan-Lottick Organizations National Cancer Institute, Rockville, MD, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, Georgetown University Lombardi Comprehensive Cancer Center, Washington, DC Abstract Disclosures Research Funding No funding sources reported Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating cancer treatment-related toxicity associated with considerable discomfort, functional loss, and impaired quality of life both acutely and long-term. Unfortunately, limited prevention and treatment options for CIPN currently exist. In this portfolio analysis, we sought to describe the landscape of CIPN research and identify gaps and opportunities to meet the needs of patients with CIPN. Methods: Using the NIH Query View Report system to search all NIH-funded competitive grants awarded between fiscal years 2014-2023, we identified 660 grants containing text pertaining to CIPN in the Abstract or Specific Aims. Grants were then manually reviewed and 480 were excluded as not specifically addressing CIPN. We categorized the final 180 grants as preclinical, clinical, or preclinical/clinical, followed by ascertainment of preclinical model, clinical population, CIPN assessment techniques, and/or clinical trial design, as applicable. Results: Of the 180 grants, 119 were preclinical, 51 clinical, and 10 with both preclinical and clinical components. The larger number of CIPN grants (n=27) were awarded in fiscal year 2022 vs. the lowest number (n=10) in 2014. Among the preclinical grants, 89% of grants utilized rodent models of CIPN, of which 19% proposed tumor-bearing models. A large majority of preclinical grants investigated paclitaxel (71%), followed by oxaliplatin (23%); none proposed studies of newer immune therapies. Among clinical grants, 41% (n=21) were interventional trials, 38% were prospective observational studies, and 15% retrospective studies. Clinical grants most frequently focused on breast cancer patients (41%), followed by unspecified cancer diagnoses (33%) and colorectal cancer (18%). For age of eligibility, 11% included patients younger than 18 years, while a higher proportion included 18-39 (82%), 40-64 (88%), and ≥65 (89%). The 21 interventional study grants investigated behavioral interventions (44%), pharmacological agents (28%), and devices (28%). Conclusions: The number of CIPN grants awarded annually by NIH have generally increased since fiscal year 2014, indicating increased investment by NIH. However, multiple gaps and opportunities remain. At the preclinical level, in addition to current rodent models and the narrow range of treatment exposures, novel strategies to mimic human CIPN conditions may improve translatability. Clinical studies are needed in younger patients that can be impacted by CIPN long-term. Also, there are important gaps in the CIPN-associated cancer diagnoses and therapy exposures (including novel agents) in current studies. Addressing the highlighted gaps may identify avenues to study additional interventions that achieve the highest impact in the populations that most need them.

Pre-clinical