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CSTR Lab

What is the purpose of PAC-AI?

Chemotherapy-related cognitive impairment (CRCI) affects an estimated 60% of patients, negatively impacting quality of life. Currently, there is no established method for predicting which patients will develop CRCI. This information could be practice-changing by assisting clinicians with treatment decision-making for individual patients.

We have shown that the brain network (“connectome”) is significantly altered in patients with CRCI. In an earlier study, we measured the connectome in patients prior to any treatment and showed that these brain network properties could be used in combination with machine learning to predict 1 year post-chemotherapy cognitive impairment with 100% accuracy.

The proposed project aims to test this prediction model in a new, larger sample with the overarching goal of validating its use for clinical practice. We will enroll 50 newly diagnosed patients with primary breast cancer scheduled for adjuvant chemotherapy who will be assessed prior to any treatment, including surgery with general anesthesia, 1 month after chemotherapy treatment and again 1 year later. We will also enroll matched healthy female controls who will be assessed at the same time points.

Data from healthy controls will be used to determine impairment status in patients with breast cancer and to provide a template of typical connectome organization for comparison.

We hypothesize that our machine learning model will accurately predict 1 year post- chemotherapy cognitive impairment and that it will be more accurate than a model that includes patient history and medical information alone. We will also examine the changes in brain networks over time. This information will provide novel insights regarding the neural mechanisms of CRCI and may also help us refine our prediction models. 

 

RELEVANCE 

A significant proportion of women who receive chemotherapy for breast cancer will experience long- term problems with brain function, such as thinking, memory and attention that reduce quality of life and extend disease-related disability. The proposed study aims to validate a model for predicting who will develop long-term cognitive impairment and to examine the underlying causes of this impairment. This research is highly relevant to breast cancer, one of the most common public health problems, affecting 1 in 8 women. 

For potential participants:

Who is eligible for PAC-AI?

If you are a female with newly diagnosed breast cancer and you have not yet received any chemotherapy or radiation treatment, or have completed chemotherapy at least one month ago, you may be eligible for PAC-AI. 

Inclusion Criteria for Newly Diagnosed Breast Cancer Patients:

  • Female with newly diagnosed breast cancer
  • Have not started chemotherapy or radiation treatment 
  • Are age 35-68 years old
  • Scheduled for chemotherapy 

Exclusion Criteria for Newly Diagnosed Breast Cancer Patients:

  • Have begun chemotherapy or radiation treatment for breast cancer diagnosis
  • Currently pregnant
  • History of neurologic or psychiatric conditions or cancers unrelated to BC
  • Other major medical conditions that would lead to unstable health
  • Any contraindications to MRI such as: Pacemakers, certain metal implants, severe claustrophobia,  pregnancy

Inclusion Criteria for Survivors:

  • Female breast cancer survivors
  • Have completed chemotherapy at least one month ago
  • Aged 35-68 years old

Exclusion Criteria for Survivors:

  • Currently pregnant
  • History of neurologic or psychiatric conditions or cancers unrelated to BC
  • Other major medical conditions that would lead to unstable health
  • Any contraindications to MRI such as: Pacemakers, certain metal implants, severe claustrophobia, pregnancy

If you are interested in taking part in this research study, please contact our team at cancerwellness@vcuhealth.org or by calling (804) 628-8869. We look forward to speaking with you!

What is the purpose of Brief Behavioral Therapy for Cancer Related Insomnia (BBT-CI) and Healthy Eating Education Learning (HEAL)?

The study is being done to answer the following question:

  • Which treatment, Brief Behavioral Therapy (BBT-CI) or Healthy Eating Education Learning (HEAL), works better to reduce insomnia?

We are conducting this study because we want to find out if one of these approaches is better or worse for managing insomnia in cancer patients.

Sleep problems such as insomnia, are common for cancer patients. Insomnia can be described as difficulty falling asleep, waking up many times during the night or waking up earlier than you would like. Insomnia can increase fatigue and worsen your quality of life.

For potential participants:

Who is eligible for Brief Behavioral Therapy for Cancer Related Insomnia (BBT-CI) and Healthy Eating Education Learning (HEAL)?

Inclusion Criteria

  • Male or Female
  • Be at least 18 years of age
  • Be diagnosed with Cancer (stage I, II, III, or IV) with a life expectancy of at least 12 months
  • Be currently receiving any cancer treatment (surgery alone is excluded)
  • Report sleep disturbance of 3 or greater on the sleep disturbance question: “Rate your sleep disturbance in the past 2 weeks on a scale from 0-10, 0 is no problems and 10 is having the most severe problems”
  • Have a score of 2, 1, or 0 on the ECOG performance status scale
  • Be able to speak, understand and read English to participate in the study assessments and interventions

Exclusion Criteria

  • Have a clinical diagnosis of Obstructive Sleep Apnea or Restless Leg Syndrome (even if controlled)
  • Be engaged in a formal Cognitive Behavioral Therapy for Insomnia program presently or in the past 30 days. Use of sleep medications are allowed.

If you are interested in taking part in this research study, please contact our team at cancerwellness@vcuhealth.org or by calling (804) 628-8869. We look forward to speaking with you!