# Spinal cord stimulation for the attenuation of chemotherapy-induced peripheral neuropathy and enhanced chemotherapeutic efficacy

> **NIH NIH K08** · JOHNS HOPKINS UNIVERSITY · 2021 · $282,426

## Abstract

Project Summary
Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting side effect of cancer
treatment drugs that often presents as debilitating pain in a stocking-and-glove distribution. One plausible
solution is spinal cord stimulation (SCS), a minimally invasive treatment used for refractory neuropathic pain
conditions, yet the utility in CIPN pain treatment is unclear. SCS was historically thought to mediate pain
inhibition via the gate-control theory, whereby electrical stimulation of the dorsal column activates Aβ afferents,
which then inhibit nociceptive afferents (Aδ and C fibers); however, novel waveforms act independent of Aβ
activation and a number of non-neuronal mechanisms have been proposed. Accordingly, the long-term goals
of this application are to delineate the neuroimmune mechanisms of SCS-induced CIPN pain inhibition. The
central hypothesis is that SCS can prevent CIPN pain and enhance chemo-efficacy. This hypothesis will be
tested by pursuing three specific aims: 1) Determine the electrical parameters of SCS for prevention of painful
CIPN and the underlying neuroimmune mechanisms in the rodent PNS. 2) Determine the vascular and
immune mechanisms of SCS-enhanced chemo-efficacy in the tumor microenvironment of human non-small
cell lung carcinoma (NSCLC). 3) Elucidate CIPN-associated mechanisms of neuronal hyperexcitability and
neuropathic pain in human dorsal root ganglia (DRG). The proposed studies take advantage of state-of-the-art
neuroscience tools (calcium imaging, electrophysiology) coupled with cancer-biology and neuroimmunology to
delineate how SCS mediates CIPN pain inhibition and enhances paclitaxel efficacy. This work is significant
with direct translational relevance since rational SCS parameter selection for CIPN pain treatment and
improved chemo-efficacy will lead to improved patient outcomes. Dr. Eellan Sivanesan is a clinician-scientist
whose career goals are to become an independently funded cancer pain researcher and a leader in the field of
neuromodulation. Dr. Sivanesan will work closely with his mentorship team to develop expertise in cancer-
biology, neuroimmunology, and cancer pain. This training will be accomplished primarily through hands-on
experiments under supervision of his mentors, as well as structured didactic and non-didactic training,
individualized instruction through regular meetings with his mentors, and systematic evaluations. Dr.
Sivanesan will be conducting his research within Johns Hopkins University School of Medicine’s Department of
Anesthesiology, a thriving academic, clinical, and research environment with exceptional facilities for early
stage investigators.

## Key facts

- **NIH application ID:** 10301067
- **Project number:** 1K08CA255428-01A1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Eellan Sivanesan
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $282,426
- **Award type:** 1
- **Project period:** 2021-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10301067

## Citation

> US National Institutes of Health, RePORTER application 10301067, Spinal cord stimulation for the attenuation of chemotherapy-induced peripheral neuropathy and enhanced chemotherapeutic efficacy (1K08CA255428-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10301067. Licensed CC0.

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