The University of Cincinnati Cancer Center Survivorship Pilot Project Award Program is generously supported by the Schiff Family Foundation Cancer Survivorship Research Fund. Two $50,000 awards are granted annually for a two-year period to support research related to cancer survivorship. The most recent cycle awarded Anthony Faiola, PhD, MFA, and Matia B. Solomon, PhD.

The goals of the Survivorship Pilot Project Award Program are to:

• Encourage interaction, collaboration, and facilitation of exploratory research to test interventions, develop research methodologies, and explore novel areas of research in cancer survivorship.
• Promote the entry of young investigators into the field of cancer survivorship research.
• Generate preliminary data for projects that will lead to external funding and ultimately have a positive impact on cancer survivorship care.

Measuring the Feasibility/Acceptability and Effect of a Virtual Reality Cognitive Training Intervention for Brain Cancer Survivors with Cancer-Related Cognitive Impairment

Anthony Faiola, PhD, MFA Associate Member, Cancer Risk, Prevention & Surveillance Research Program University of Cincinnati Cancer Center Professor, Department of Population Health University of Cincinnati College of Nursing

With an estimated 25,400 new cases and 18,760 deaths, brain cancer is the ninth leading cause of cancer death in the United States. Emerging evidence indicates that between the time of diagnosis and up to six months post-treatment, 50% to 80% of brain cancer survivors experience cognitive dysfunction. Within the glioblastoma population specifically, cognitive impairment is consistently identified as the most prevalent and distressing survivorship concern, with reported rates of cognitive decline reaching up to 91%. Cancer-related cognitive impairment (CRCI) is increasingly recognized as a persistent and disabling sequela affecting as many as 75% of brain cancer survivors, with deficits commonly reported in memory, attention, processing speed, and executive function.

“This research addresses a critical aspect of cancer survivorship: the pervasive and often debilitating cognitive impairment experienced by millions of cancer patients in the U.S. and globally, largely resulting from chemotherapy-induced neurotoxicity,” Anthony Faiola, PhD, MFA, a population scientist at the Cancer Center said. “Current interventions, including pharmacologic agents, occupational therapy and neuropsychological approaches, have shown limited efficacy. Moreover, pharmacological treatments frequently carry significant side effect profiles, underscoring the need for non-invasive, low-risk alternatives that can effectively restore cognitive function.”

One promising avenue lies in the stimulation of neuroplasticity—sometimes referred to as neurogenesis—through targeted cognitive engagement. This process may involve the regeneration of synaptic connections or the formation of novel neural pathways to support memory formation, attention and executive function.

“We posit that immersive virtual reality (VR) applications offer a novel and highly effective modality for delivering structured cognitive rehabilitation,” Faiola shared. “Unlike commercial off-the-shelf games, which may offer incidental cognitive engagement, our approach is grounded in clinical neuroscience and tailored explicitly to activate, challenge, and support key cognitive domains, including working memory, visuospatial processing, attention, executive functioning and cognitive flexibility—within a safe and controlled 3D environment. Patients must engage actively with the environment by navigating and solving complex tasks, promoting adaptive neural changes through repetitive and targeted stimulation.”

Computerized cognitive training, including gaming, has demonstrated efficacy in improving cognitive outcomes among individuals with stroke, dementia and Parkinson’s disease. However, there remains a critical need to develop and evaluate novel, scalable interventions specifically targeting CRCI within the brain cancer population.

The primary objective of this project is to assess the feasibility, acceptability, and preliminary efficacy of a virtual reality cognitive rehabilitation training (VR-CRT) platform designed to improve cognitive performance in BCS with CRCI over a 4-week intervention period.

“Our design framework draws selectively from principles of game theory to enhance user engagement; however, the core objectives, content, and mechanics are rooted in cognitive rehabilitation science,” he explained. “In Phase 2 of this project, we will integrate artificial intelligence (AI) into the platform to enable adaptive gameplay, predictive modeling of user behavior, and real-time tailoring of task difficulty and content, thereby optimizing therapeutic outcomes.”

In accepting the award, Dr. Faiola emphasized its significance for advancing patient-centered care and recognized the Cancer Center as a hub for meaningful research partnerships.

“This award is one small but very important step toward validating the importance of VR technology in supporting cancer survivorship, including improving both patient cognitive function and overall quality of life,” Faiola said. “Being a Cancer Center member has allowed me access to not only funding but also and more importantly engagement with some of the most brilliant minds and dedicated researchers and physicians in cancer research and survivorship. Like me, these people are extremely passionate about their work, and they mean business with respect to their mission at the Cancer Center.” 

Exploring Preventative Treatments for 'Chemo Brain' in a Preclinical Model of Breast Cancer

Matia B. Solomon, PhD Associate Member, Signaling Networks & Metabolic Pathways Research Program University of Cincinnati Cancer Center Associate Professor, Department of Psychology University of Cincinnati College of Arts & Sciences

Breast cancer survival rates have significantly improved in recent decades, largely due to advancements in early detection and treatment. Consequently, survivorship issues, such as chemotherapy-induced cognitive impairment, have received increased attention. Cognitive impairment, often referred to as “chemo brain” or “brain fog,” is a common side effect of chemotherapy for breast cancer, and can involve difficulties with memory, attention and executive function.

Over 30% of breast cancer survivors experience persistent chemotherapy-induced cognitive impairment (CICI), with symptoms that may endure for years following treatment. Affected cognitive domains include verbal, visual, episodic and autobiographical memory, as well as executive functioning, processing speed and sustained attention. The hippocampus—a critical brain region involved in memory consolidation—is particularly susceptible to CICI.

Existing in vivo models of CICI in breast cancer lack the complexity required to capture the multifaceted interactions between tumors, the immune system and chemotherapeutic agents seen in human patients. To address this gap, Matia Solomon, PhD, a behavioral neuroscientist affiliated with the Cancer Center, and her team propose leveraging triple-negative breast cancer (TNBC) as a model system, given its common treatment with chemotherapy and the availability of robust, immunocompetent murine models.

“Currently, research models that accurately reflect the interaction between breast cancer, the immune system, and treatments in humans are limited—especially for ER+ breast cancer,” Solomon said. “TNBC, on the other hand, is better suited for research because it is primarily treated with chemotherapy and likely has stronger animal models.”

“Despite growing interest in understanding CICI, many preclinical research studies often lack collaboration between neuroscientists and cancer researchers,” she explained. “As a result, many studies fail to capture how cancer and its treatment affect the whole body, especially the brain, because of their overreliance of preclinical models that lack a working immune system or do not fully mimic long-term cognitive effects. Few studies have used models that include tumors, chemotherapy and a functioning immune system, and even fewer have combined behavioral testing with molecular studies to understand the root causes of CICI.”

To strengthen this study’s foundation, Solomon is building on a decade-long interdisciplinary collaboration with molecular biologist Lisa Privette Vinnedge, PhD.

“My long-time collaborator and friend, Dr. Lisa Privette Vinnedge, and I have been studying the role of the oncogene DEK in learning, memory and Alzheimer's disease for almost a decade,” Solomon shared. “We have determined that the loss of this oncogene leads to features of Alzheimer’s disease, a debilitating neurodegenerative disease characterized by memory loss. This research naturally led to my interest in understanding the impact of cancer treatment, particularly breast cancer treatment, on short-term and long-term cognitive outcomes in women.”

“Given that many women experience cognitive impairment during and after chemotherapy, we aim to shed light on the underlying factors of this condition,” she said. “Ultimately, we hope to develop effective strategies to prevent or reduce the occurrence of cognitive impairment with breast cancer treatment.”

Currently, there are no proven treatments that prevent CICI. Solomon and her team aim to identify novel, non-invasive methods to help protect the brain from the potentially damaging effects of chemotherapy. To do this, they are borrowing a method from the stroke field that is commonly employed to attenuate neuroinflammation and DNA damage, both of which are associated with cognitive impairment.

“We will integrate behavioral cognitive testing with cellular and molecular analyses to elucidate the underlying mechanisms of chronic CICI and determine whether this novel method has any potential therapeutic value,” Solomon explained. “Positive findings will serve as the foundation for a future R01 application aimed at evaluating the efficacy of this technique in preserving cognitive function in the context of chemotherapy.” 

Reflecting on the significance of the award and the project’s future impact, Dr. Solomon shared her vision for translating laboratory findings into real-world solutions for cancer survivors.

“This award grants us the ability to assess the translational value of our proposed methods with hopes that it will allow us to adopt a bench-to-bedside approach in finding solutions to prevent 'chemo brain,’” she said. “If this project is successful, we plan to pilot a project in a clinical setting to determine if our proposed low-stakes, non-invasive strategy can help alleviate this potentially long-term, debilitating side effect of chemotherapy. Ultimately, we hope that this can improve the quality of life for many during what is undoubtedly a difficult time.”