National Cancer Institute-supported chemotherapy-induced peripheral neuropathy trials: outcomes and lessons

Support Care Cancer. 2016 Mar;24(3):1439-47. doi: 10.1007/s00520-015-3063-4. Epub 2015 Dec 19.

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and debilitating complications of cancer treatment. Due to a lack of effective management options for patients with CIPN, the National Cancer Institute (NCI) sponsored a series of trials aimed at both prevention and treatment. A total of 15 such studies were approved, evaluating use of various neuro-modulatory agents which have shown benefit in other neuropathic pain states. Aside from duloxetine, none of the pharmacologic methods demonstrated therapeutic benefit for patients with CIPN. Despite these disappointing results, the series of trials revealed important lessons that have informed subsequent work. Some examples of this include the use of patient-reported symptom metrics, the elimination of traditional--yet unsubstantiated--practice approaches, and the discovery of molecular genetic predictors of neuropathy. Current inquiry is being guided by the results from these large-scale trials, and as such, stands better chance of identifying durable solutions for this treatment-limiting toxicity.

Keywords: Cancer; Chemotherapy; Clinical trials; Peripheral neuropathy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Humans
  • National Cancer Institute (U.S.)
  • Peripheral Nervous System Diseases / chemically induced*
  • Treatment Outcome
  • United States

Substances

  • Antineoplastic Agents