We propose to test whether H1 and H2 clustering can distinguish patients responsive or resistant to the combination therapy with immunotherapy in a prospective clinical study.

We will assess physical functioning, daily physical activity with wearable activity monitors, biological markers (serum and salivary cortisol), diet, program adherence, as well as psycho-social measures of physical, mental, and spiritual wellbeing. In addition, BCS will be asked to describe their best day possible and their typical day. We will conduct a qualitative analysis from their responses to identify endorsement of themes.

This is a translational clinical study aiming to develop approaches to process effectively human tissues and identify biomarkers for painful and non-painful chemotherapy-induced peripheral neuropathy (CIPN). This study will involve obtaining two skin biopsies representing affected and non-affected parts of each patient’s limb. Painful and non-painful neuropathies will be determined by a variety of standard approaches implemented by a neurologist Dr. Bhavaraju-Sanka.