Altshuler Rachel D, Minasian Lori M, Schweppe Catherine A, Kadan-Lottick Nina S
Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.
Department of Oncology Cancer Prevention and Control Program, Georgetown University Lombardi Comprehensive Cancer Center, Washington, DC, United States.
JNCI Cancer Spectr. 2025 Apr 30;9(3). doi: 10.1093/jncics/pkaf039.
Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating acute and long-term toxicity in cancer patients. We sought to describe the landscape of CIPN research funded by the National Institutes of Health (NIH) and identify gaps and opportunities.
Using the NIH Query View Report system, we identified 180 competitive grants between 2014-2023 containing text pertaining to CIPN in the Abstract or Specific Aims. These were categorized as preclinical, clinical, or both and described by preclinical model, clinical population, CIPN assessments, and/or clinical trial design. We identified 5 additional NCI-funded trials through the NCORP network pertaining to CIPN.
Of 185 studies, 125 were preclinical, 56 clinical, and 4 both preclinical/clinical. Among preclinical studies, most studies used rodent CIPN models, of which 17% were tumor-bearing. Most preclinical studies investigated paclitaxel; none studied newer immune therapies. The 60 clinical studies were 53% observational and 47% interventional, focusing most frequently on breast cancer, unspecified cancers, and colorectal cancer diagnoses. Overall, 8% included patients <18 years, whereas a higher proportion included those 18-39 (85%), 40-64 (90%), and ≥65 (92%). Among 28 interventional trials, studies investigated behavioral interventions (39%), pharmacological agents (32%), and devices (29%).
The number of CIPN grants awarded by NIH since 2014 represents a substantial investment, but critical gaps and opportunities remain. Preclinically, novel strategies to mimic human CIPN may improve translatability. Important gaps in CIPN-associated cancer diagnoses and therapy exposures, including novel agents, would benefit from future research. Also, clinical studies are needed in young patients with potential long-term CIPN.
化疗引起的周围神经病变(CIPN)是癌症患者中一种使人衰弱的急性和长期毒性反应。我们试图描述由美国国立卫生研究院(NIH)资助的CIPN研究概况,并找出差距和机会。
使用NIH查询视图报告系统,我们在2014年至2023年间识别出180项竞争性拨款,其摘要或具体目标中包含与CIPN相关的文本。这些拨款被分类为临床前、临床或两者皆有,并根据临床前模型、临床人群、CIPN评估和/或临床试验设计进行描述。我们通过NCORP网络识别出另外5项由美国国立癌症研究所(NCI)资助的与CIPN相关的试验。
在185项研究中,125项为临床前研究,56项为临床研究,4项为临床前/临床研究。在临床前研究中,大多数研究使用啮齿动物CIPN模型,其中17%为荷瘤模型。大多数临床前研究调查了紫杉醇;没有研究新型免疫疗法。60项临床研究中,53%为观察性研究,47%为干预性研究,最常关注的癌症诊断为乳腺癌、未明确的癌症和结直肠癌。总体而言,8%的研究纳入了年龄小于18岁的患者,而纳入18 - 39岁(85%)、40 - 64岁(90%)和65岁及以上(92%)患者的比例更高。在28项干预性试验中,研究调查了行为干预(39%)、药物制剂(32%)和设备(29%)。
自2014年以来,NIH授予的CIPN拨款数量代表了大量投资,但关键差距和机会仍然存在。在临床前,模拟人类CIPN的新策略可能会提高可转化性。CIPN相关癌症诊断和治疗暴露方面的重要差距,包括新型药物,将受益于未来的研究。此外,需要对可能发生长期CIPN的年轻患者进行临床研究。