Neurogastric electrical stimulation for treating chemotherapy-induced emesis

描述（申请人提供）：癌症是一组以异常细胞不受控制的生长和扩散为特征的疾病。每年有超过一百万人患癌症。大约每两个美国男性中就有一个和每三个美国女性中就有一个会在他们一生中的某个时候患上某种癌症。顺铂是癌症化疗中最常用的药物之一。然而，化疗引起的严重不良事件，主要是恶心和呕吐，对患者来说可能比未来对预期寿命的担忧更令人痛苦。事实上，一些患者因为严重的顺铂引起的恶心和呕吐而选择停止潜在的治疗。

DESCRIPTION (provided by applicant): Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. Over one million people get cancer each year. Approximately one out of every two American men and one out of every three American women will have some type of cancer at some point during their lifetime. Cisplatin is one of the most commonly used drugs in chemotherapy for cancers. However, severe adverse events resulting from chemotherapies, mainly nausea and vomiting may be much more distressing to a patient than future concerns of life expectancy. In fact, some patients choose to discontinue potentially curative therapy because of severe Cisplatin-induced nausea and vomiting. Antiemetic agents are the most common intervention in the management of chemotherapy-induced nausea and vomiting in cancer patients. The basis for antiemetic therapy is the neurochemical control of vomiting. However, currently, there are no satisfactory therapies for treating chemotherapy-induced emesis, especially delayed emesis. Neurogastric electrical stimulation (nGES) has recently been proposed and found effective in treating nausea and vomiting in patients with gastroparesis. Its central and neuronal mechanisms have recently been elucidated. It is hypothesized that nGES is effective in treating chemotherapy-induced emesis. The long-term aim of this project is to develop an endoscopically implantable microstimulator for the treatment of chemotherapy-induced emesis. The aim of this Phase I project is to study the feasibility of this novel method for treating chemotherapy- induced emesis. Specific objectives include a feasibility study in an animal model of Cisplatin-induced emesis, central and neuronal mechanistic studies involving nGES and optimization of the nGES therapy based on the mechanisms of action. A competitive team has been established, including experts in gastrointestinal electrical stimulation, physiology of the central nervous system and micro-stimulators. PUBLIC HEALTH RELEVANCE: Chemotherapy-induced emesis is one of major problems in the treatment of patients with cancer and occurs in more than 90% of cases with certain medications, such as Cisplatin. With the recent advancement of anti-emetic medications, acute emesis is better controlled; however, delayed emesis remains a big challenge. A novel method of neurogastric electrical stimulation (nGES) is proposed in this project for the treatment of chemotherapy-induced emesis. Preliminary data supports this novel concept and experiments are designed to test the feasibility of the proposed method.