Noah Kolb, M.D. (Photo: David Seaver)

Chemotherapy is a highly effective cancer treatment, but it frequently comes with a side effect that significantly affects patients’ quality of life. Between half and three quarters of all chemotherapy patients — more than half a million Americans annually — suffer a condition called chemotherapy-induced peripheral neuropathy, or CIPN, at the end of their treatment. Many experience severe pain, sensory loss and balance issues. Care is often inadequate, especially in rural areas, where few providers have expertise in treating CIPN symptoms.

The situation is about to improve. The National Cancer Institute (NCI) has awarded Noah Kolb, M.D., associate professor of neurological sciences at the University of Vermont's Larner College Medicine, and a team of researchers a $7 million grant to develop a new intervention for chemo-induced neuropathy, one that can be as easily implemented in rural areas as large urban centers. Kolb is also a member of the University of Vermont Cancer Center and a neurologist at the University of Vermont Medical Center.

The study, which launches in 2022, will enroll 420 patients. The premise brings together technology and science. Using an app, website or automated phone system, all patients will report their symptoms. When participants in the intervention group report moderate or severe symptoms, a same-day call-back will be triggered from a nurse practitioner trained in management of CIPN. 

Could Also Help Curtail Opioid Dependence

Nurses will follow a detailed, evidence-based algorithm to respond to symptoms. The benefit to patients is an immediate response and more effective pain management. While the main goal of the study is to improve symptoms, researchers also hope to show that effectively treating symptoms with the right medications will reduce opiate use in this population, which is at higher risk for opiate dependence. 

Serving rural populations is a critical focus of the UVM Cancer Center under the leadership of Randall Holcombe, M.D., M.B.A., its new director. “Programs such as this one directed by Dr. Kolb have the potential to greatly impact, in a positive way, the quality of life of cancer patients. In addition, the intervention is one that will be easily translatable to rural communities here in Vermont and elsewhere.”

“Chemotherapy-induced nerve damage is an understudied complication of cancer therapy,” said Gregory Holmes, M.D., chair of neurological sciences at the Larner College of Medicine. “While the emphasis in treating individuals with cancer is stopping the growth of the cancer, little attention has been paid to the devastating effect of the therapy. In this study, Dr. Kolb and colleagues have developed a robust follow-up program with patients with cancer, hoping to delineate those individuals at risk and developing interventional techniques to help mitigate this prevalent co-morbidity of cancer. Only through close follow-up of individuals with cancer who receive chemotherapy will there be therapeutic beak throughs in interventional techniques. This study will provide valuable information to investigators involved in the treatment of individuals with cancer.” 

Kolb and colleagues will begin enrolling patients in a clinical trial, called Remote monitoring and management of chemotherapy induced peripheral neuropathy, as early as January 2022. For more information about the UVM Cancer Center, including information about clinical trials, please visit: https://go.uvm.edu/cancerscience.

Gordon Smith, M.D., professor and chair of neurology at the Virginia Commonwealth University’s College of Medicine, and Kathi Mooney, M.D., Louis S. Peery and Janet B. Peery Presidential Endowed Chair in Nursing at the University of Utah, are co-primary investigators on the project.

About the University of Vermont Cancer Center
The University of Vermont Cancer Center is Vermont’s only not-for-profit comprehensive clinical and research cancer center. Founded in 1974, the organization is located within the University of Vermont Larner College of Medicine and enjoys a clinical partnership with the University of Vermont Medical Center. Drawing on the expertise of more than 225 researchers and clinicians at the university and the medical center, the UVM Cancer Center has an ongoing commitment to innovative cancer research, life-saving prevention and treatment programs, ongoing clinical and public education, and reducing the cancer burden in the community.