Chemotherapy-induced peripheral neuropathy research: a National Institutes of Health (NIH) grant portfolio analysis...

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating acute and long-term toxicity in cancer patients. We sought to describe the landscape of CIPN research funded by the National Institutes of Health (NIH) and identify gaps and opportunities.

Using the NIH Query View Report system, we identified 180 competitive grants between 2014-2023 containing text pertaining to CIPN in the Abstract or Specific Aims. These were categorized as preclinical, clinical, or both and described by preclinical model, clinical population, CIPN assessments, and/or clinical trial design. We identified 5 additional NCI-funded trials through the NCORP network pertaining to CIPN.

Of 185 studies, 125 were preclinical, 56 clinical, and 4 both preclinical/clinical. Among preclinical studies, most studies used rodent CIPN models, of which 17% were tumor-bearing. Most preclinical studies investigated paclitaxel; none studied newer immune therapies. The 60 clinical studies were 53% observational and 47% interventional, focusing most frequently on breast cancer, unspecified cancers, and colorectal cancer diagnoses. Overall, 8% included patients <18 years, whereas a higher proportion included those 18-39 (85%), 40-64 (90%), and ≥65 (92%). Among 28 interventional trials, studies investigated behavioral interventions (39%), pharmacological agents (32%), and devices (29%).

The number of CIPN grants awarded by NIH since 2014 represents a substantial investment, but critical gaps and opportunities remain. Preclinically, novel strategies to mimic human CIPN may improve translatability. Important gaps in CIPN-associated cancer diagnoses and therapy exposures, including novel agents, would benefit from future research. Also, clinical studies are needed in young patients with potential long-term CIPN.