Hemotherapy-related cognitive impairment (CRCI) is a significant problem that develops in up to 75% of breast cancer patients, often persisting for many years and significantly impairing quality of life. The etiology of CRCI is not clearly understood, and there are no effective management approaches. Reduction of inflammation is a promising target to alleviate CRCI, and translational investigators well versed in clinical and behavioral research, immunology and neuroscience are needed to advance knowledge in this area. Dr. Michelle Janelsins, an Assistant Professor in the Department of Radiation Oncology at the University of Rochester Medical Center, is applying for a K07 mentored career development award to expand her clinical and behavioral research skills and to integrate new skills with her strong basic science abilities as an independent clinical and translational cancer control investigator with expertise in interventions for CRCI. This application provides Dr. Janelsins with new training and skills necessary to develop, implement, and assess interventions in a clinical setting and combine these new abilities with her established skills and knowledge in immunology and neuroscience to successfully conduct the first randomized, controlled, pilot study we are aware of investigating the influence of two novel interventions (exercise and ibuprofen) on CRCI and inflammation. Career Development Plan: Dr. Janelsins'previous training provides an outstanding initial foundation, but she needs new training in the conduct of Phase II-III clinical trials, cognitive assessment and related bio behavioral immune pathways, and exercise intervention development to become a successful independent clinical researcher with expertise in bio behavioral research focusing on understanding and alleviating CRCI. Her four career development training goals are: 1) to develop expertise in cancer control Phase II-III clinical trials, 2) to develop expertise in cognitive science and cognitive assessments and related bio behavioral immune pathways, 3) to develop expertise in exercise physiology, physical activity assessments and exercise interventions, and 4) to promote the development of an independent academic research career. Dr. Janelsins has an outstanding mentoring team: Dr. Gary Morrow, a leading cancer control researcher with NCI funding for over thirty years, is her senior mentor;Drs. Tim Ahles and Deborah Cory-Slechta provide expertise in neurocognitive testing as her co-mentors;Dr. Karen Mustian provides expertise in exercise interventions as a co-mentor;and advisors Drs. Jan Moynihan (immunology), Michelle Shayne (medical oncology), and Charles Heckler (biostatistics) provide specific expertise in key areas. Research Plan: The proposed Phase II RCT, based partially on Dr. Janelsins'preliminary data, is a three-arm study comparing the influence of ibuprofen + health education (Arm 1), placebo + exercise (Arm 2) and placebo + health education (control;Arm 3) on CRCI in 120 breast cancer patients undergoing chemotherapy experiencing CRCI. The exercise and ibuprofen arms will each be compared to the control (Arm 3) with the primary goal of assessing, analyzing, and interpreting the preliminary efficacy of each intervention in alleviating CRCI and the effects of each intervention on inflammation. This award will position Dr. Janelsins to become a leader in the cancer and cognition field who, over her career, will make meaningful contributions to patient care. Research findings will be used to design future definitive RCTs, ensure Dr. Janelsins'successful transition to an independent, R01- funded, clinical and translational investigator, and ultimately reduce the public health burden from CRCI.
Up to 75% of cancer patients experience chemotherapy-related cognitive impairment (CRCI), often termed chemobrain, which can last for many years after treatment. These difficulties in cognitive functioning, such as problems with memory, can impair a patient's ability to carry out routine daily activities. There are no effective treatments for CRCI and the exact etiology is unknown. This project will provide information on two possible interventions for CRCI and explore mechanisms of intervention effects.
|Janelsins, Michelle C; Heckler, Charles E; Thompson, Bryan D et al. (2016) A clinically relevant dose of cyclophosphamide chemotherapy impairs memory performance on the delayed spatial alternation task that is sustained over time as mice age. Neurotoxicology 56:287-293|
|Williams, A M; Janelsins, M C; van Wijngaarden, E (2016) Cognitive function in cancer survivors: analysis of the 1999-2002 National Health and Nutrition Examination Survey. Support Care Cancer 24:2155-62|
|Janelsins, Michelle C; Peppone, Luke J; Heckler, Charles E et al. (2016) YOCASÂ©Â® Yoga Reduces Self-reported Memory Difficulty in Cancer Survivors in a Nationwide Randomized Clinical Trial: Investigating Relationships Between Memory and Sleep. Integr Cancer Ther 15:263-71|
|Conley, Claire C; Kamen, Charles S; Heckler, Charles E et al. (2016) Modafinil Moderates the Relationship Between Cancer-Related Fatigue and Depression in 541 Patients Receiving Chemotherapy. J Clin Psychopharmacol 36:82-5|
|Kamen, Charles; Mustian, Karen M; Heckler, Charles et al. (2015) The association between partner support and psychological distress among prostate cancer survivors in a nationwide study. J Cancer Surviv 9:492-9|
|Kerns, Sarah L; Kundu, Suman; Oh, Jung Hun et al. (2015) The Prediction of Radiotherapy Toxicity Using Single Nucleotide Polymorphism-Based Models: A Step Toward Prevention. Semin Radiat Oncol 25:281-91|
|Kamen, Charles; Heckler, Charles; Janelsins, Michelle C et al. (2015) A Dyadic Exercise Intervention to Reduce Psychological Distress Among Lesbian, Gay, and Heterosexual Cancer Survivors. LGBT Health :|
|Peppone, Luke J; Janelsins, Michelle C; Kamen, Charles et al. (2015) The effect of YOCASÂ©Â® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Res Treat 150:597-604|
|Kamen, Charles; Blosnich, John R; Lytle, Megan et al. (2015) Cigarette Smoking Disparities among Sexual Minority Cancer Survivors. Prev Med Rep 2:283-286|
|Mustian, Karen M; Janelsins, Michelle; Peppone, Luke J et al. (2014) Yoga for the Treatment of Insomnia among Cancer Patients: Evidence, Mechanisms of Action, and Clinical Recommendations. Oncol Hematol Rev 10:164-168|
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