Neurogastric electrical stimulation for treating chemotherapy-induced emesis

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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.