Chemotherapy-induced peripheral neuropathy research: a National Institutes of Health (NIH) grant portfolio analysis (2014-2023).

Background: 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.

Methods: 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.

Results: Of 185 studies, 125 were preclinical, 56 clinical, and 4 both preclinical/clinical. Among pre-clinical studies, most studies utilized 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, while 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%).

Conclusions: The number of CIPN grants awarded by NIH since 2014 represent 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.