Abstract
BACKGROUND: Neurologic complications of cancer and cancer therapy are highly prevalent and disruptive adverse events affecting both the central and peripheral nervous systems. These complications, including peripheral neuropathy and cognitive decline, often lead to treatment disruption and diminished quality of life. With limited effective therapies, early recognition is vital for timely intervention and proactive management to improve patient outcomes. The University of Texas MD Anderson Cancer Center NeuroHealth Initiative (NHI) is a novel program designed to standardize multimodal assessment of neurological function throughout cancer treatment. It also provides a platform for longitudinal data collection and in-depth biospecimen analysis to characterize predictive factors and optimize risk assessment for neurotoxicities. METHODS: The NHI is a multidisciplinary collaboration structured as a clinical workflow with an associated research component, bridging various oncology clinics and the Brain and Spine Center. Enrollment occurs in progressive phases starting in cancer site-specific clinics, from which eligible patients are referred by their treating oncologists to the NHI. Evaluations are conducted longitudinally, beginning with a baseline visit, and include standardized neurological assessment, focused neuropsychological assessment, blood sampling, and patient-reported outcomes. Participants may opt for additional research procedures including detailed neurocognitive monitoring, quantitative neurosensory measurements, advanced neuroimaging, stool microbiome collection, and CSF sampling. If clinically significant neurologic conditions are identified, patients are referred to appropriate specialists. The first phase of enrollment began with the ovarian cancer patient cohort in November 2024. As of June 2025, 29 patients have been enrolled, with 6 consenting to the additional research arm. CONCLUSION: The NHI is pioneering a standardized workflow that will both provide immediate clinical impact through serial neurologic assessments as well as support research to identify, monitor, and ultimately prevent emerging neurotoxicities associated with cancer and cancer treatment.