# Assessing the role of the interoceptive brain system in the pathophysiology and treatment of chemotherapy-induced peripheral neuropathy

> **NIH NIH R21** · UNIVERSITY OF ROCHESTER · 2021 · $351,324

## Abstract

PROJECT SUMMARY/ABSTRACT
Chemotherapy-induced peripheral neuropathy (CIPN) is a severe dose-limiting toxicity that affects over 65% of
the roughly 250,000 patients per year receiving neurotoxic chemotherapy (e.g., taxane-, platinum-, vinca
alkaloid-based), which is widely used for breast, prostate, lung, colorectal, and blood cancers among others.
Not only does CIPN increase mortality by limiting the dose of chemotherapy, CIPN affects walking, writing,
eating, and dressing via numbness, tingling, pain, cold sensitivity, and cramping in the hands and feet. There
are no FDA-approved treatments for CIPN because we need a greater understanding of the pathophysiology
of CIPN and mechanisms of action of promising treatments for CIPN. To date, most research on CIPN
pathophysiology has focused on peripheral sensory nerve damage. This project is motivated by an innovative
perspective that CIPN symptoms are not due simply to peripheral nerve damage, but rather that CIPN
symptoms are worsened by damage to the interoceptive brain system (i.e., the brain’s reaction to peripheral
nerve damage). The long-term vision for this project is mechanism-based CIPN sub-typing and mechanism-
based treatments for CIPN informed by brain fMRI, as has been done in other brain-mediated conditions such
as chronic pain and depression.
This is a Phase II randomized clinical trial to assess CIPN and fMRI brain connectivity in the interoceptive brain
system in 66 patients with CIPN from neurotoxic chemotherapy before and after 6 weeks of exercise vs. usual
care. This study will be included as part of the clinical trial URCC 19075. The specific aims of this project are
(1) to obtain preliminary estimates of the relationships between CIPN and functional connectivity in the
interoceptive brain system in patients with CIPN, and (2) to obtain preliminary estimates of the effects of
exercise vs. no exercise on both CIPN severity and functional connectivity in the interoceptive brain system in
patients with CIPN.
This is the first study to examine the interoceptive brain system in the pathophysiology and treatment of CIPN.
Results from this study will inform an R01 application to more definitively assess this theory of CIPN and
exercise. If this work is successful, it will reveal a novel objective biomarker of CIPN—functional connectivity in
the interoceptive brain system—to improve prediction, tracking, sub-typing, and treatment of CIPN using
exercise or other interventions that affect this brain system. This will ultimately help alleviate the burden of
chemotherapy on treating patients with cancer.
Chair: Ian Kleckner

## Key facts

- **NIH application ID:** 10288334
- **Project number:** 1R21CA256154-01A1
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Ian Robert Kleckner
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $351,324
- **Award type:** 1
- **Project period:** 2021-09-22 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10288334

## Citation

> US National Institutes of Health, RePORTER application 10288334, Assessing the role of the interoceptive brain system in the pathophysiology and treatment of chemotherapy-induced peripheral neuropathy (1R21CA256154-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10288334. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*