Chemotherapy-induced peripheral neuropathy

Abstract

Despite the volume of recent publications, there are limited preventive or therapeutic strategies for CIPN supported by high-level evidence. Duloxetine remains the only pharmacologic agent with demonstrated benefit; its clinical use should be routinely considered. Moving forward, nonopioid analgesic therapies will likely play an increasing role in CIPN treatment, but further research is necessary to confirm their utility. Promising therapies include vitamin B12 supplementation, physical therapy, and various forms of neuromodulation.

Phase I Dose-Escalation Study of SCB01A, a Microtubule Inhibitor with Vascular Disrupting Activity, in Patients with Advanced Solid Tumors

“…Neurological toxicity has been a commonly reported DLT during the clinical development of tubulin-binding agents and could not be effectively prevented or treated [22][23][24][25]. Similar recoverable peripheral sensorimotor neuropathy in this trial was observed when 65 mg/m 2 CA4P was administered to Chinese patients with grade 2 lower extremity weakness [21]. These were not seen in western patients.…”

“…AEs and efficacies observed in this study were similar to those reported for VDAs (Table 4). The partial response in one patient with buccal cancer was consistent with the activity of combretastatin A-4 phosphate (CA4P) in Chinese patients with refractory nasopharyngeal carcinoma [21]. Neurological toxicity has been a commonly reported DLT during the clinical development of tubulin-binding agents and could not be effectively prevented or treated [22][23][24][25].…”

“…The partial response in one patient with buccal cancer was consistent with the activity of CA4P in Chinese patients with refractory nasopharyngeal carcinoma [21]. Neurological toxicity has been a commonly reported DLT during the clinical development of tubulin-binding agents and could not be effectively prevented or treated [22][23][24][25]. Similar recoverable peripheral sensorimotor neuropathy in this trial was observed when 65 mg/m 2 CA4P was administered to Chinese patients with G2 lower extremity weakness [21].…”

Fast onset of relief after topical phenytoin in neuropathic pain after chemotherapy

“…Adverse events frequently lead to a reduction of chemotherapy dosage or even to discontinuation of therapy. Clinical effects of analgesics in this population are small [7].…”

Późne działania niepożądane uzupełniającego leczenia systemowego u chorych z rozpoznaniem raka piersi.

“…Niestety, nie dysponujemy wiarygodnymi, potwierdzonymi naukowo metodami leczenia w przypadku stwierdzenia objawów polineuropatii obwodowej. Jedynym lekiem, którego działanie zostało udowodnione jest duloxetyna [22]. Obiecujące wydają się rezultaty suplementacji witaminy B12, fizykoterapii czy różnych form neuromodulacji-wymagają jednak potwierdzenia w dalszych badaniach.…”