# Effects of exercise during platinum chemotherapy on neuropathy: examining the interoceptive brain system and inflammation

> **NIH NIH R21** · UNIVERSITY OF MARYLAND BALTIMORE · 2022 · $216,686

## Abstract

PROJECT SUMMARY/ABSTRACT
Chemotherapy-induced peripheral neuropathy (CIPN) is a severe dose-limiting toxicity that affects over 65% of
patients receiving platinum-based chemotherapy for gastrointestinal cancers. 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. In addition, most research on CIPN in humans has focused on taxane-based
chemotherapy in patients with breast cancer. Here, we are focusing on platinum-based chemotherapy in patients
with gastrointestinal cancers because taxane- and platinum-induced CIPN are both very common but exhibit
distinct signs, symptoms, and mechanisms of toxicities, and may respond differently to a given treatment. 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—which
processes sensations from the body—as well as systemic inflammation.
This is a Phase II randomized clinical trial to assess the effects of 12 weeks of exercise during platinum
chemotherapy on CIPN, interoception, and inflammation in 60 patients with gastrointestinal cancer. The specific
aims of this project are to assess the effects of exercise vs. nutrition education (control) on: (1) patient reported
CIPN, (2) clinical assessments of CIPN (tactile sensitivity and cold-induced pain), (3) interoception (functional
connectivity in the interoceptive brain system and self-report), and (4) inflammation (serum inflammatory
cytokines).
This is the first study to examine the effects of exercise during platinum chemotherapy on CIPN and to examine
roles of interoception and inflammation in the treatment of platinum-induced 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,
we will have identified an effective intervention (exercise) for alleviating CIPN and we will have a better
understanding of how exercise alleviates CIPN (i.e., interoception and inflammation). We believe this knowledge
can be applied to improve prediction, tracking, sub-typing, and treatment of CIPN using exercise or other
interventions that affect these pathways. This will ultimately help alleviate the burden of chemotherapy on treating
patients with cancer.

## Key facts

- **NIH application ID:** 10355322
- **Project number:** 1R21CA259422-01A1
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Ian Robert Kleckner
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $216,686
- **Award type:** 1
- **Project period:** 2022-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10355322

## Citation

> US National Institutes of Health, RePORTER application 10355322, Effects of exercise during platinum chemotherapy on neuropathy: examining the interoceptive brain system and inflammation (1R21CA259422-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10355322. Licensed CC0.

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