(PQ9) Mitigation of chemotherapy induced peripheral neuropathy



 DESCRIPTION (provided by applicant): Lung cancer is currently a leading cause of mortality. One of these serious neurotoxic side effects that develop in lung cancer patients receiving chemotherapeutic agents is chemotherapy-induced peripheral neuropathy (CIPN). Our proposal will be focused on CIPN induced by cisplatin and paclitaxel since these are two of the most effective and widely used chemotherapy drugs in the treatment of common cancers, including non- small cell lung cancer. CIPN can be a dose-limiting factor for chemotherapy or result in premature termination of treatment, thereby influencing survival and quality of life. Currently, there are no effective therapies that deal with the underlying pathogenic mechanisms such as neurodegeneration. In addition, the current symptomatic therapies that deal with painful symptoms of CIPN are generally ineffective. Therefore, the identification of alternative forms of therapy is a crucial medical need. In this application we will focus on nicotinic acetylcholine receptors (nAChRs) modulators, in particular α7 subtypes, as potential targets for treatment of CIPN. These receptors are expressed by central and peripheral neuronal cells (dorsal root ganglia) involved in pain transmission and by macrophages and other cells involved in the inflammatory responses. In Aim 1, we will test the ability of α7 nAChR silent agonists to prevent or ameliorate the development of peripheral neuropathy induced by cisplatin and paclitaxel, including well- defined neuropathologies that accompany CIPN. In Aim 2, we will test the α7 nAChR silent agonists in non-small cell lung cancer cell lines and patient derived tumor cells in culture as well as in tumor bearing mice to eliminate the possibility that these agents stimulate tumor growth or compromise the potency of chemotherapy (cisplatin and paclitaxel). In addition, suppression of CIPN by the α7 nAChR silent agonists will be confirmed in the tumor bearing mice. If effective treatment/prevention can be identified, it should be possible to treat patients or prolonged periods as dose-dependent neuropathy will not be a limiting toxicity and compliance as well as quality of life will be improved.