Early Detection of Taxane-induced Neuropathy in Women with Breast Cancer

乳腺癌女性紫杉烷诱发神经病变的早期检测

基本信息

批准号：
8908163
负责人：
Noah Robert Zanville
金额：
$ 2.99万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8908163
关键词：
Abraxane Accidents Address Adverse effects Age Antineoplastic Agents Area Axon Blood Vessels Blood flow Breast Cancer survivor C Fiber Caliber Chemotherapy-induced peripheral neuropathy Data Decision Making Development Diabetic Neuropathies Dose Early Diagnosis Education Educational process of instructing Exposure to Fiber Fingers Flare Foundations Health Health Personnel Heating Injury Knowledge Life Limb structure Measurement Measures Mediating Methods Monitor Nerve Nerve Fibers Neuropathy Occupational Outcome Outcome Measure Outcome Study Paclitaxel Pain Patient Outcomes Assessments Patient Self-Report Patients Pharmaceutical Preparations Physical Function Play Provider Quality of life Questionnaires Race Reflex action Research Risk Role Safety Sampling Severities Signal Transduction Skin Symptoms Taxane Compound Techniques Temperature Testing Time Toes Training Woman afferent nerve career chemotherapy daily functioning duloxetine effective therapy falls gabapentin hereditary neuropathy improved malignant breast neoplasm meetings painful neuropathy prevent primary outcome programs public health relevance skills skills training survivorship taxane tool tool development

项目摘要

DESCRIPTION (provided by applicant): The proposed training plan will provide the applicant with the foundation of knowledge, training, and skills needed to begin his interdisciplinary, translational program of research. This research focuses on the development of tools for measuring chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer survivors (BCS) who have received the chemotherapy drug paclitaxel (Taxol(r), Abraxane(r)). Although paclitaxel is highly effective as a treatment for both metastatic and non-metastatic breast cancer, exposure to paclitaxel leads to CIPN in 50-80% of BCS who receive the drug. The impact of CIPN on BCS can be severe; symptoms can interfere with occupational function and quality of life, and in some cases, force providers to stop potentially life-saving chemotherapy. Because of significant risk that CIPN symptoms pose to BCS' ability to complete treatment, function, and maintain quality of life, it is critical to identify CIPN as early as possible and monitor its progression carefully during treatment. Identifying CIPN as early as possible can alert providers to BCS at risk for severe symptoms, allowing providers to initiate teaching to minimize safety risks (e.g., falls, accidents) and initiate treatment with available agents (e.g., duloxetine, gabapentin). As treatment progresses, accurate monitoring of CIPN can help providers determine if chemotherapy needs to be delayed or discontinued and provide the team with information needed to help women plan for survivorship. Unfortunately, while early detection and accurate monitoring are important to managing CIPN effectively, current approaches to measuring CIPN are poorly suited to meet these needs. Common strategies for assessing CIPN like neuropathy grading scales or self-report questionnaires can be effective for measuring the severity and type of CIPN symptoms once they've started, but cannot detect the early signs of CIPN needed to predict symptoms and are vulnerable to patient underreporting. These approaches also lack the ability to target damage to specific types of nerves. This is especially important in the case of c-fibers, which are involved in pain signaling and increasingly have been shown to play a role in the development and perpetuation of CIPN. Recent studies have identified an accurate, sensitive approach for measuring c-fiber neuropathy that holds promise for detecting and monitoring CIPN in BCS. The approach involves measuring the increase in blood flow to the skin after stimulating temperature-sensitive nerves (c-fibers) with a heat probe (which is known as an axon reflex). Axon reflexes can be stimulated in as short a time as 20 minutes using simple heat probes, opening the door to a clinically feasible method for detecting and monitoring CIPN. The purpose of this study is to determine if axon reflexes can be used to accurately measure c-fiber damage (CIPN) in BCS receiving weekly paclitaxel.

描述（由应用程序提供）：拟议的培训计划将为应用程序的基础提供知识，培训和技能的基础，以开始他的跨学科，翻译的研究计划。这项研究的重点是开发用于乳腺癌存活（BCS）中化学疗法诱导的周围神经病（CIPN）的工具，这些（BCS）已接受化学疗法药物紫杉醇（紫杉醇（R），Abraxane（R））。尽管紫杉醇作为转移性乳腺癌和非转移性乳腺癌的治疗方法非常有效，但接触紫杉醇会导致50-80％接受该药物的BC中的CIPN。 CIPN对BCS的影响可能很严重；症状会干扰职业功能和生活质量，在某些情况下，迫使提供者停止潜在的挽救生命的化学疗法。由于CIPN症状构成BCS完成治疗，功能和维持生活质量的能力的重大风险，因此至关重要的是尽早识别CIPN并在治疗过程中仔细监测其进展。尽早识别CIPN可以提醒提供者注意有严重症状的BCS，使提供者可以启动教学以最大程度地减少安全风险（例如瀑布，事故），并使用可用试剂（例如Duloxetine，Gabapentin）启动治疗。 CIPN可以帮助提供者确定是否需要延迟或中断化疗，并为团队提供帮助妇女计划生存所需的信息。不幸的是，尽管早期检测和准确的监测对于有效地管理CIPN很重要，但是当前测量CIPN的方法非常适合满足这些需求。评估CIPN等常见的策略，例如神经病分级量表或自我报告问卷调查，一旦启动，CIPN症状的严重程度和类型可以有效，但无法检测到需要预测症状的早期迹象，并且容易受到患者不足的症状。这些方法还缺乏针对特定类型神经损害的能力。在C纤维的情况下，这尤其重要，c纤维参与疼痛信号并越来越多已显示在CIPN的开发和持续性中发挥作用。最近的研究已经确定了一种测量C纤维神经病的准确，敏感的方法，该方法有望在BCS中检测和监测CIPN。该方法涉及测量用A刺激温度敏感神经（C纤维）的血液流向皮肤的增加热探针（称为轴突反射）。轴突反射可以在短短20分钟的时间内使用简单的热探针刺激，这为检测和监测CIPN的临床可行方法打开了门。这项研究的目的是确定是否可以使用轴突反射来准确测量每周接收紫杉醇的BC中的C纤维损伤（CIPN）。