Institutional Career Development Core

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This proposed KL2 supplement award will provide Dr. Blake Langley, ND, MS, LAc with the necessary protected time, resources, didactic training, and mentored guidance from an interdisciplinary team to develop into an independent researcher. The planned completion of a master's degree in Epidemiology is a critical component to achieving independence as a researcher. The intensive mentorship, pragmatic experience, and clinical-didactic training over three years will provide fundamental training to a clinician-scholar in the design, collection, analysis, and interpretation of both mechanistic biomarker data and patient-reported outcomes. The proposed research project will generate preliminary data for future grant applications addressing the prevention and treatment of a serious illness: anorexia, the abnormal loss of appetite for food. Anorexia contributes to malnourishment and is a predecessor to cachexia (weight loss >5% of total body weight) in cancer, chronic obstructive pulmonary disease, chronic kidney disease, and congestive heart failure. Cachexia is implicated in up to 20% of cancer-related deaths, poses a risk to an estimated 60-70% of patients with pancreatic and gastric cancer, and is associated with negative impacts on quality of life, treatment adherence, and overall survival. A growing body of research supports acupuncture as an efficacious intervention for anorexia, while auricular acupressure, an acupuncture technique without infection risk that uses seeds from the Vaccaria segetalis plant, may target multiple mechanisms of actions that address cachexia risk factors. Auricular acupressure interventions must consider the feasibility and acceptability to specific populations, including patients and providers. The broad objective of the scholar's research project is to train an early career investigator on the design, conduct, and analysis of a pilot and feasibility trial of an auricular acupressure intervention delivered in a multidisciplinary outpatient setting. The proposed study is an 8-week randomized, controlled pilot and feasibility trial of auricular acupressure plus standard care (active arm) vs standard care only (control arm). Auricular acupressure ear seeds will be applied weekly and maintained for five days after each application for 8 weeks. Participants will gently stimulate each seed bilaterally for three minutes, three times per day. The primary aim of the trial is to assess the feasibility and acceptability of an auricular acupressure intervention to improve appetite prevent weight loss in 66 adults with pancreatic and gastroesophageal cancer with low appetite. The secondary aim is to estimate the effect size and variance in weight loss and change in appetite for future studies on the efficacy of auricular acupressure in cancer patients with low appetite. The exploratory aim will examine potential inflammatory mechanisms by which auricular acupressure impacts weight loss and appetite, and the intervention's impact on quality of life. The results of this trial will inform future studies on the efficacy of such an intervention and should be applicable to future research on anorexia and cachexia in both cancer and non-cancer populations.