Project Summary
The overall goal of this 4-year K23 proposal is to support Dr. Stephani Stancil to become an independent
investigator in the field of pharmacodynamic biomarker development to support quantitative early-stage drug
development in pediatric neuropsychopharmacology, specifically eating disorder therapeutics. This proposal
aligns with NIMH’s prioritization of and the National Advisory Mental Health Council workgroup
recommendations for quantitative pharmacologic early-stage trials, particularly in vulnerable populations.
Eating disorders (ED), including Bulimia Nervosa, Anorexia Nervosa-Binge/Purge and Binge Eating Disorder,
are characterized by binge eating and purge behaviors (e.g., vomiting), typically begin in adolescence, and
affect up to 5% of teens. EDs are associated with significant morbidity (e.g., malnutrition, cardiac compromise,
development of substance use disorder), have the highest mortality rate of any psychiatric illness and are not
responsive to current pharmacotherapy. This career development proposal will leverage Dr. Stancil’s clinical
pharmacology expertise in drug exposure inquiry and expand her career focus to clinical
neuropsychopharmacology to enable her to define central nervous system drug action in children and
adolescents. The comprehensive career development plan (CDP) contains three training objectives: 1)
neuroimaging, 2) pediatric randomized clinical trials, and 3) exposure-response modeling, to transition Dr.
Stancil into a successful, independent investigator. The CDP’s structured mentoring, didactic training and
experiential learning will be applied to a randomized, placebo-controlled crossover trial in adolescents with
Binge/Purge ED to accomplish the following aims: Aim 1) Determine the sensitivity of a neuroimaging
biomarker to reward system modulation by opioid antagonism, Aim 2) Develop an Exposure-Response Model
for naltrexone. Dr. Stancil’s career development and research will take place in a highly favorable and well-
suited environment that includes a tertiary academic children’s medical center, children’s research institute,
joint department of pediatrics shared by two regional medical schools, an outstanding imaging center and the
Frontiers CTSA. After completing this project, Dr, Stancil will have advanced the field of pharmacodynamic
biomarker development in pediatric mental health and generated data to support an R01 application to
establish the validity of the proposed pharmacodynamic biomarker. She will be well-positioned to become a
leader in the field of pharmacodynamic biomarker development and exposure-response linkage to de-risk
early-stage drug development and facilitate a precision therapeutics approach to pediatric
neuropsychopharmacology.