Poster Presentation 2025 National Cancer Survivorship Conference

Improving symptoms and balance in cancer survivors with chemotherapy-induced peripheral neuropathy: the CanSTEP randomised controlled trial. (#148)

Jasmine Menant 1 2 , Daina Sturnieks 1 2 , Stephen Lord 1 2 , Bogda Koczwara 3 4 , Katia Ferrar 4 , Emma Kemp 4 , Patsy Yates 5 , Peter Grimison 6 , David Mizrahi 7 , Cathie Sherrington 8 , Jennifer Davis 9 , Peter Humburg 2 , David Wyld 10 , Monica Tang 11 , David Goldstein 2 11 , Susanna Park 8
  1. Neuroscience Research Australia, Randwick, NSW, Australia
  2. UNSW, Sydney
  3. Flinders Medical Centre, Adelaide
  4. Flinders University, Adelaide
  5. Queensland University of Technology, Brisbane
  6. Chris O’Brien Lifehouse, Sydney
  7. The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney
  8. University of Sydney, Sydney
  9. University of British Columbia, Vancouver, Canada
  10. Department of Medical Oncology, Royal Brisbane and Women’s Hospital, Brisbane
  11. Department of Medical Oncology, Prince of Wales Hospital, Sydney

Background: More than 30% of cancer survivors are affected by chemotherapy-induced peripheral neuropathy (CIPN) six months post-neurotoxic treatment. Despite the ever-increasing burden of CIPN-related disability in cancer survivors, current management is inadequate. Small-scale trials have demonstrated the benefits of exercise, particularly balance training, on CIPN symptom severity. However, no studies have concurrently addressed the cognitive complaints raised by 20-30% of patients caused by cancer and/or its treatments. We have demonstrated that home-based cognitive-motor step training delivered via exergames reduces falls in older people and improves balance and stepping in people with Multiple Sclerosis and Parkinson’s disease.

Aims: Building on our previous research, this randomised controlled trial will determine the effectiveness and cost-effectiveness from a health care system perspective of a 4-month cognitive-motor step training program (CanSTEP) compared with usual care, on neuropathy symptoms and balance in cancer survivors with CIPN. 

Methods: As part of this trial (ACTRN12624000865516), 178 cancer survivors with CIPN symptoms affecting the lower limbs, will be recruited. Following a baseline assessment, participants will be randomised to either intervention or wait-list control group. The intervention will involve engaging stepping exergames played at home in several sessions totalling up to 120 minutes per week. CIPN symptoms (primary outcome), incremental cost-effectiveness ratio (economic outcome), quality of life, balance and mobility, executive function and physical activity patterns will be assessed at baseline and 4-months. Patient-reported outcomes and 1-week physical activity monitoring (wrist sensor) will also be completed at a 6-month follow-up. Interviews will be conducted in a sub-sample of intervention participants to explore barriers and motivations to take up the program.

Expected outcomes and significance: Participants’ recruitment is ongoing. This trial has the potential to accelerate access to practitioners and cancer survivors with CIPN to an evidence-based rehabilitation program, ultimately reducing risks and costs associated with mobility impairment and falls.