Alfredia’s Story: Enrolling in a Clinical Trial to Help Others

After working 43 long years at Chase Bank, Alfredia Taylor finally felt ready to retire, setting March 25th as her official last day on the job. Her family was planning a retirement party for her down in South Carolina, and she looked forward to celebrating the milestone with her loved ones.

Much to her disbelief, a routine mammogram spotted a suspicious mass. Her primary care doctor recommended a sonogram followed by a biopsy. Less than two weeks into retirement, Alfredia received a diagnosis of early stage, HER2-positive breast cancer.

“You hear about people who work all their lives, and then they get cancer,” says Alfredia, 67, a resident of the Bronx, NY. “I didn’t expect it to happen to me.”

Before starting chemotherapy in August, she decided to enroll in a new clinical trial at Columbia University’s Irving Medical Center looking at ways to reduce one of the most common side effects of her breast cancer treatment.

“Chemotherapy-induced peripheral neuropathy is a potentially debilitating side effect of life-saving chemotherapy that can have long-lasting effects on patients’ quality of life,” says Melissa Accordino, MD, a member of the Herbert Irving Comprehensive Cancer Center (HICCC) and director of quality and patient safety in the Division of Hematology/Oncology at Columbia’s Vagelos College of Physicians and Surgeons. “There are currently no good treatment options for peripheral neuropathy and also no known way to prevent it.”

Peripheral neuropathy is a set of symptoms caused by nerve damage that may include feelings of numbness, tingling, weakness, or chronic pain in the hands or feet. Chemotherapy and other drugs used to treat cancer can cause neuropathy that lasts for years or even decades after treatment.

Preliminary studies have demonstrated that peripheral vasoconstriction, or restricting blood flow to patients’ hands and feet through compression, could be a viable strategy to prevent peripheral neuropathy. Because chemotherapy is administered through the bloodstream, peripheral vasoconstriction reduces the exposure of those nerves to the damaging drugs.

In the clinical trial, Accordino and her colleagues are investigating three different strategies to determine which works best for neuropathy prevention: continuous compression, low cyclic compression, or combined compression and cooling. Thirty minutes before her dose of paclitaxel, a chemotherapy drug known to cause peripheral neuropathy, Alfredia goes into a device, called the Paxman Limb Cryocompression System, made of wraps that compress the arms and legs.

“It’s kind of like a space suit,” says Alfredia, who receives continuous compression involving moderate, steady pressure to the arms and legs. “It doesn’t hurt.”

She remains in the device for the period during and 30 minutes after her chemotherapy infusion. Other patients undergo low cyclic compression (low pressure that comes and goes to the arms and legs) or cryocompression (cooling plus moderate and low pressure to the arms and legs). The clinical trial is still actively recruiting and aims to enroll a total of 777 participants.

“As cancer treatments get better and better, we really need to come up with interventions to maximize quality of life to go with that, because we don't want our patients to suffer,” says Dr. Accordino. “It is an area of huge importance at Columbia to do better in terms of reducing the long-term and lifelong potential side effects of therapies.”

“I decided to enroll because I realized that, if other women hadn’t been parts of other trials, we wouldn’t be so advanced with cancer cure as a treatment,” says Alfredia. “Hopefully, somebody else will benefit from the results of this trial, even if it’s years from now."