Neuropsychiatric symptom and biomarker changes with electroacupuncture in adolescent and young adult (AYA) cancer survivors: Results from a randomized controlled trial.

Abstract

10054 Background: Electroacupuncture (EA) shows promise for managing neuropsychiatric symptoms, yet its role in adolescent and young adult (AYA) cancer survivors remains unclear. We conducted a randomized, controlled, patient- and assessor-blinded pilot trial comparing two EA regimens to evaluate effects on neuropsychiatric symptoms and associated biomarkers in AYA cancer survivors (ClinicalTrials.gov: NCT05283577). Methods: AYA cancer survivors aged 16–39 years who self-reported cognitive impairment, fatigue, insomnia, or psychological distress were randomized (1:1) to receive ten weekly EA sessions targeting either neuropsychiatric-specific acupoints (nEA) or non-neuropsychiatric-specific acupoints (sham EA; sEA). Blood collection, neurocognitive testing (CANTAB), and patient-reported outcomes (FACT-Cog, MFSI-SF, EORTC QLQ-C30) were obtained at four timepoints. Sixteen plasma cytokines were measured using ProcartaPlex immunoassays, and brain-derived neurotrophic factor (BDNF) concentrations were quantified using ELISA. Between-group effects were evaluated with linear mixed models and expressed as Cohen's d (positive values favor nEA). Adverse events (AEs) were graded using CTCAE v5.0. Results: Thirty-four AYAs participated (mean age 20.9 ± 3.5 years; 59% Hispanic/Latino; 59% hematologic and 21% CNS cancers). Most (82%) reported ≥2 neuropsychiatric symptoms at baseline. Completion of all EA sessions was comparable between study arms (nEA: 64.7%; sEA: 70.6%). A positive dose-response relationship was observed, with approximately half reporting at least one improved symptom after 5 weeks of treatment (nEA: 53.8%; sEA: 60.0%) and >80% reporting improvement at 4 weeks post-treatment (nEA: 80.0%; sEA: 92.3%). At 4-week follow-up, greater improvement in self-reported cognitive function favored sEA ( d = −1.017, p < 0.05), accompanied by between-group differences in BDNF ( d = −1.073, p < 0.05), IL-10 ( d = 1.378, p < 0.05), and RANTES ( d = 1.058, p < 0.05). All AEs were grade ≤ 2; tremors and pain were the most commonly reported. Conclusions: AYAs across both EA regimens demonstrated meaningful improvements in neuropsychiatric symptoms, accompanied by corresponding biomarker changes. However, maximal benefit occurred among participants who completed all scheduled sessions, underscoring the importance of strategies to optimize EA session adherence in this population. These findings support the feasibility of EA in AYAs and inform the design of larger trials. Clinical trial information: NCT05283577 .