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Test to predict if chemotherapy will cause delayed nausea is brainchild of Main Line Health researcher

Lankenau Medical Center April 18, 2022 Medical Research

The effects of chemotherapy can be debilitating, especially nausea. While it generally can be managed in the clinic, many patients aren't struck until later at home—and may wind up in the emergency room.

A blood test called MyNauseaRisk that can identify patients at risk of severe delayed nausea is the brainchild of Maggie Wallon, PhD, assistant professor at Lankenau Institute for Medical Research, part of Main Line Health. The test allows doctors to prescribe personalized antinausea combinations to at-risk patients with chemotherapy, blunting this effect.

"During our study, when patients started treatments and were asked if they wanted to participate, basically every one of them said yes," Wallon said. "That's how debilitating the nausea can be."

Nausea has been reported in studies as the most feared side effect of chemotherapy. Delayed nausea, which can occur on days 2 through 5 after chemotherapy, has been found to occur in at least 50% of patients undergoing treatment for the first time. Preventing delayed nausea with oral medication at home is simpler and more effective than trying to treat it once it occurs.

Preventing delayed nausea with oral medication at home is simpler and more effective than trying to treat it once it occurs.

The idea came about when oncologists at Lankenau Medical Center talked to Wallon about addressing delayed nausea. Little did they realize she had a candidate for a blood test in hand.

How MyNauseaRisk is different from most chemotherapy agents

Most chemotherapy agents cause bursts of reactive oxygen species (ROS) that irritate cells in the digestive system and trigger the release of transmitters that cause nausea. Glutathione (GSH) is a key antioxidant that neutralizes ROS and is a biomarker for moderate to severe delayed nausea. Patients with greater GSH recycling capacity have a lower risk of developing it. Wallon's lab test measures recycling capacity by testing patients' blood samples.

No extra blood draws would be required to undergo the MyNauseaRisk test. It can be run using the same samples collected when a patient undergoes bloodwork before being cleared to begin chemotherapy. Results take two hours.

Clinical studies performed at Main Line Health showed the results were powerful. The test correctly classified nearly 90 percent of patients experiencing high nausea sensitivity. The results were published in a paper that was chosen for presentation in 2016 at the annual American Society of Clinical Oncology meeting in Chicago. Paul Gilman, MD, director of the Clinical Research Center at LIMR, who attended in Wallon's place since she was out of the country, was besieged.

"The presentation was so popular that they ran out of handouts," said Wallon, disappointed she missed the spectacle. "He had to find a copy store and get more handouts."

Cancer patients across the globe can benefit from the test, Wallon said, sparing them considerable suffering and likely keeping many chemotherapy patients on their treatment plan who might otherwise give in to the severe side effects.

Cancer patients across the globe can benefit from the test, Wallon said, sparing them considerable suffering and likely keeping many chemotherapy patients on their treatment plan who might otherwise give in to the severe side effects.

"Those who are at risk of delayed nausea shouldn't be given an Rx for antiemetics to be filled 'as needed,'" Wallon said. "It should be 'fill and take for X number of days.'"

LIMR signed a licensing agreement in 2020 with MYNARI Biomedical, a biotech startup that is working to commercialize the product. Wallon is certain that the demand among patients and clinicians will grow.

LIMR, working with L2C Partners of Wynnewood, seeks to bring MyNauseaRisk as well as other blood tests and medical technologies into society. View full list of LIMR-developed IP and technologies available for licensing.