Abstract
Pharmacological treatment of chemotherapy-induced peripheral neuropathy (CIPN) is still in its infancy and available options are limited. Both American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology-European Oncology Nursing Society-European Association of Neuro-Oncology (ESMO-EONS-EANO) guidelines recommend the use of duloxetine for treatment of CIPN. The ESMO-EONS-EANO suggest gabapentinoids (pregabalin and gabapentin), tricyclic antidepressants, and opioids may be considered as an option to relieve neuropathic pain where duloxetine cannot be used. The National Comprehensive Cancer Network (NCCN) guidelines do not address CIPN specifically, but consider gabapentinoids (pregabalin and gabapentin) first-line options for cancer-related neuropathic pain. Currently, none of these guidelines recommend the use of any supplements but they recommend against use of acetyl-l-carnitine due to harm seen in preventions studies. The ESMO guidelines also recommend use of topical menthol but recommend against the use of topical ketamine and amitriptyline. Despite limited options currently available, multiple studies are ongoing and further treatment choices may become available in the future.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Smith EM, Pang H, Cirrincione C, Fleishman S, Paskett ED, Ahles T et al (2013) Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial. JAMA 309(13):1359–1367. https://doi.org/10.1001/jama.2013.2813. PubMed PMID: 23549581; PubMed Central PMCID: PMCPMC3912515
Smith EM, Pang H, Ye C, Cirrincione C, Fleishman S, Paskett ED et al (2017) Predictors of duloxetine response in patients with oxaliplatin-induced painful chemotherapy-induced peripheral neuropathy (CIPN): a secondary analysis of randomised controlled trial - CALGB/alliance 170601. Eur J Cancer Care (Engl) 26(2):e12421. https://doi.org/10.1111/ecc.12421. PubMed PMID: 26603828; PubMed Central PMCID: PMCPMC4879099
Avan R, Janbabaei G, Hendouei N, Alipour A, Borhani S, Tabrizi N et al (2018) The effect of pregabalin and duloxetine treatment on quality of life of breast cancer patients with taxane-induced sensory neuropathy: A randomized clinical trial. J Res Med Sci 23:52. https://doi.org/10.4103/jrms.JRMS_1068_17. PubMed PMID: 30057636; PubMed Central PMCID: PMCPMC6040148
Hirayama Y, Ishitani K, Sato Y, Iyama S, Takada K, Murase K et al (2015) Effect of duloxetine in Japanese patients with chemotherapy-induced peripheral neuropathy: a pilot randomized trial. Int J Clin Oncol 20(5):866–871. Epub 2015/03/13. PubMed PMID: 25762165. https://doi.org/10.1007/s10147-015-0810-y
Farshchian N, Alavi A, Heydarheydari S, Moradian N (2018) Comparative study of the effects of venlafaxine and duloxetine on chemotherapy-induced peripheral neuropathy. Cancer Chemother Pharmacol 82(5):787–793. https://doi.org/10.1007/s00280-018-3664-y. PubMed PMID: 30105459
Gewandter JS, Kleckner AS, Marshall JH, Brown JS, Curtis LH, Bautista J et al (2020) Chemotherapy- induced peripheral neuropathy (CIPN) and its treatment: an NIH Collaboratory study of claims data. Support Care Cancer 28(6):2553–2562. https://doi.org/10.1007/s00520-019-05063-x. PubMed PMID: 31494735; PubMed Central PMCID: PMCPMC7060096
Hershman DL, Lacchetti C, Dworkin RH, Lavoie Smith EM, Bleeker J, Cavaletti G et al (2014) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American society of clinical oncology clinical practice guideline. J Clin Oncol 32(18):1941–1967. https://doi.org/10.1200/JCO.2013.54.0914. PubMed PMID: 24733808
Loprinzi CL, Lacchetti C, Bleeker J, Cavaletti G, Chauhan C, Hertz DL et al (2020) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline update. J Clin Oncol. https://doi.org/10.1200/jco.20.01399. PubMed PMID: 32663120
Fallon M, Giusti R, Aielli F, Hoskin P, Rolke R, Sharma M et al (2018) Management of cancer pain in adult patients: ESMO clinical practice guidelines. Annals Oncol 29:iv166–iv191. https://doi.org/10.1093/annonc/mdy152
Jordan B, Margulies A, Cardoso F, Cavaletti G, Haugnes HS, Jahn P et al (2020. Epub 2020/08/03. PubMed PMID: 32739407) Systemic anticancer therapy-induced peripheral and central neurotoxicity: ESMO-EONS-EANO clinical practice guidelines for diagnosis, prevention, treatment and follow-up. Ann Oncol. https://doi.org/10.1016/j.annonc.2020.07.003
NCCN Clinical practice guidelines in oncology-adult cancer pain (Version 1). 2020. Epub April 8
Durand JP, Deplanque G, Montheil V, Gornet JM, Scotte F, Mir O et al (2012) Efficacy of venlafaxine for the prevention and relief of oxaliplatin-induced acute neurotoxicity: results of EFFOX, a randomized, double-blind, placebo-controlled phase III trial. Ann Oncol 23(1):200–205. https://doi.org/10.1093/annonc/mdr045. PubMed PMID: 21427067
Zimmerman C, Atherton PJ, Pachman D, Seisler D, Wagner-Johnston N, Dakhil S et al (2016) MC11C4: a pilot randomized, placebo-controlled, double-blind study of venlafaxine to prevent oxaliplatin-induced neuropathy. Support Care Cancer 24(3):1071–1078. https://doi.org/10.1007/s00520-015-2876-5. PubMed PMID: 26248652; PubMed Central PMCID: PMCPMC4939800
Song SY, Ko YB, Kim H, Lee GW, Yang JB, Chang HK et al (2020) Effect of serotonin-norepinephrine reuptake inhibitors for patients with chemotherapy-induced painful peripheral neuropathy: A meta-analysi. Medicine (Baltimore) 99(1):e18653. https://doi.org/10.1097/MD.0000000000018653. PubMed PMID: 31895829; PubMed Central PMCID: PMCPMC6946453
Calandre EP, Rico-Villademoros F, Slim M (2016) Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use. Expert Rev Neurother 16(11):1263–1277. https://doi.org/10.1080/14737175.2016.1202764
Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P (2010) A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet 49(10):661–669. Epub 2010/09/08. PubMed PMID: 20818832. https://doi.org/10.2165/11536200-000000000-00000
Pachman DR, Watson JC, Lustberg MB, Wagner-Johnston ND, Chan A, Broadfield L et al (2014) Management options for established chemotherapy-induced peripheral neuropathy. Support Care Cancer 22(8):2281–2295. Epub 2014/06/01. PubMed PMID: 24879391. https://doi.org/10.1007/s00520-014-2289-x
Magnowska M, Iżycka N, Kapoła-Czyż J, Romała A, Lorek J, Spaczyński M et al (2018) Effectiveness of gabapentin pharmacotherapy in chemotherapy-induced peripheral neuropathy. Ginekol Pol 89(4):200–204. Epub 2018/05/22. PubMed PMID: 29781075. https://doi.org/10.5603/GP.a2018.0034
Saif MW, Syrigos K, Kaley K, Isufi I (2010) Role of pregabalin in treatment of oxaliplatin-induced sensory neuropathy. Anticancer Res 30(7):2927–2933. Epub 2010/08/05. PubMed PMID: 20683034
Rao RD, Michalak JC, Sloan JA, Loprinzi CL, Soori GS, Nikcevich DA et al (2007) Efficacy of gabapentin in the management of chemotherapy-induced peripheral neuropathy: a phase 3 randomized, double-blind, placebo-controlled, crossover trial (N00C3). Cancer 110(9):2110–2118. Epub 2007/09/14. PubMed PMID: 17853395. https://doi.org/10.1002/cncr.23008
Hincker A, Frey K, Rao L, Wagner-Johnston N, Ben Abdallah A, Tan B et al (2019) Somatosensory predictors of response to pregabalin in painful chemotherapy-induced peripheral neuropathy: a randomized, placebo-controlled, crossover study. Pain 160(8):1835–1846. https://doi.org/10.1097/j.pain.0000000000001577. Epub 2019/07/25. PubMed PMID: 31335651; PubMed Central PMCID: PMCPMC6687437 the end of this article
Rao RD, Flynn PJ, Sloan JA, Wong GY, Novotny P, Johnson DB et al (2008) Efficacy of lamotrigine in the management of chemotherapy-induced peripheral neuropathy: a phase 3 randomized, double- blind, placebo-controlled trial, N01C3. Cancer 112(12):2802–2808. Epub 2008/04/23. PubMed PMID: 18428211. https://doi.org/10.1002/cncr.23482
Loprinzi CL, Lacchetti C, Bleeker J, Cavaletti G, Chauhan C, Hertz DL et al (2020. Epub 2020/07/15. PubMed PMID: 32663120) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline update. J Clin Oncol. https://doi.org/10.1200/jco.20.01399
Swarm RA, Paice JA, Anghelescu DL, Are M, Bruce JY, Buga S et al (2019) Adult Cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw 17(8):977–1007. Epub 2019/08/08. PubMed PMID: 31390582. https://doi.org/10.6004/jnccn.2019.0038
Ibrahim SA, Albany Z, Albany C (2015) Significant response to lacosamide in a patient with severe chemotherapy-induced peripheral neuropathy. J Community Support Oncol 13(5):202–204. Epub 2015/06/02. PubMed PMID: 26029937. https://doi.org/10.12788/jcso.0136
Hearn L, Derry S, Moore RA (2012) Lacosamide for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2:Cd009318. Epub 2012/02/18. PubMed PMID: 22336864. https://doi.org/10.1002/14651858.CD009318.pub2
de Greef BTA, Hoeijmakers JGJ, Geerts M, Oakes M, Church TJE, Waxman SG et al (2019) Lacosamide in patients with Nav1.7 mutations-related small fibre neuropathy: a randomized controlled trial. Brain 142(2):263–275. https://doi.org/10.1093/brain/awy329
Cartoni C, Brunetti GA, Federico V, Efficace F, Grammatico S, Tendas A et al (2012) Controlled- release oxycodone for the treatment of bortezomib-induced neuropathic pain in patients with multiple myeloma. Support Care Cancer 20(10):2621–2626. Epub 2012/06/16. PubMed PMID: 22699304. https://doi.org/10.1007/s00520-012-1511-y
Kim BS, Jin JY, Kwon JH, Woo IS, Ko YH, Park SY et al (2018) Efficacy and safety of oxycodone/naloxone as add-on therapy to gabapentin or pregabalin for the management of chemotherapy-induced peripheral neuropathy in Korea. Asia Pac J Clin Oncol 14(5):e448–ee54. Epub 2017/12/28. PubMed PMID: 29280313. https://doi.org/10.1111/ajco.12822
Liu YC, Wang WS (2012) Human mu-opioid receptor gene A118G polymorphism predicts the efficacy of tramadol/acetaminophen combination tablets (ultracet) in oxaliplatin-induced painful neuropathy. Cancer 118(6):1718–1725. Epub 2011/08/13. PubMed PMID: 21837673. https://doi.org/10.1002/cncr.26430
Raptis E, Vadalouca A, Stavropoulou E, Argyra E, Melemeni A, Siafaka I (2014) Pregabalin vs. opioids for the treatment of neuropathic cancer pain: a prospective, head-to-head, randomized, open-label study. Pain Pract 14(1):32–42. Epub 2013/03/08. PubMed PMID: 23464813. https://doi.org/10.1111/papr.12045
Saarto T, Wiffen PJ (2007) Antidepressants for neuropathic pain. Cochrane Database Syst Rev 4:CD005454. Epub 2007/10/19. PubMed PMID: 17943857. https://doi.org/10.1002/14651858.CD005454.pub2
Hammack JE, Michalak JC, Loprinzi CL, Sloan JA, Novotny PJ, Soori GS et al (2002) Phase III evaluation of nortriptyline for alleviation of symptoms of cis-platinum-induced peripheral neuropathy. Pain 98(1–2):195–203. Epub 2002/07/06. PubMed PMID: 12098632. https://doi.org/10.1016/s0304-3959(02)00047-7
Kautio AL, Haanpaa M, Saarto T, Kalso E (2008) Amitriptyline in the treatment of chemotherapy- induced neuropathic symptoms. J Pain Symptom Manag 35(1):31–39. Epub 2007/11/06. PubMed PMID: 17980550. https://doi.org/10.1016/j.jpainsymman.2007.02.043
Hershman DL, Unger JM, Crew KD, Minasian LM, Awad D, Moinpour CM et al (2013) Randomized double-blind placebo-controlled trial of acetyl-L-carnitine for the prevention of Taxane-induced neuropathy in women undergoing adjuvant breast Cancer therapy. J Clin Oncol 31(20):2627–2633. https://doi.org/10.1200/jco.2012.44.8738
Hershman DL, Unger JM, Crew KD, Till C, Greenlee H, Minasian LM et al (2018) Two-year trends of Taxane-induced neuropathy in women enrolled in a randomized trial of acetyl-L-carnitine (SWOG S0715). JNCI: Journal of the National Cancer Institute 110(6):669–676. https://doi.org/10.1093/jnci/djx259
Stubblefield MD, Vahdat LT, Balmaceda CM, Troxel AB, Hesdorffer CS, Gooch CL (2005) Glutamine as a neuroprotective agent in high-dose paclitaxel-induced peripheral neuropathy: a clinical and Electrophysiologic study. Clin Oncol 17(4):271–276. https://doi.org/10.1016/j.clon.2004.11.014
Jackson DV, Wells HB, Atkins JN, Zekan PJ, White DR, Richards F et al (1988) Amelioration of vincristine neurotoxicity by glutamic acid. Am J Med 84(6):1016–1022. https://doi.org/10.1016/0002-9343(88)90306-3
Boyle FM, Wheeler HR, Shenfield GM (1999) J Neuro-Oncol 41(2):107–116. https://doi.org/10.1023/a:1006124917643
Sands S, Ladas EJ, Kelly KM, Weiner M, Lin M, Ndao DH et al (2016) Glutamine for the treatment of vincristine-induced neuropathy in children and adolescents with cancer. Support Care Cancer 25(3):701–708. https://doi.org/10.1007/s00520-016-3441-6
Loven D, Levavi H, Sabach G, Zart R, Andras M, Fishman A et al (2009) Long-term glutamate supplementation failed to protect against peripheral neurotoxicity of paclitaxel. Eur J Cancer Care 18(1):78–83. https://doi.org/10.1111/j.1365-2354.2008.00996.x
Nishioka M, Shimada M, Kurita N, Iwata T, Morimoto S, Yoshikawa K et al (2011) The Kampo medicine, Goshajinkigan, prevents neuropathy in patients treated by FOLFOX regimen. Int J Clin Oncol 16(4):322–327. https://doi.org/10.1007/s10147-010-0183-1
Kimata Y, Ogawa K, Okamoto H, Chino A, Namiki T (2016) Efficacy of Japanese traditional (Kampo) medicine for treating chemotherapy-induced peripheral neuropathy: A retrospective case series study. World J Clin Cases 4(10):310. https://doi.org/10.12998/wjcc.v4.i10.310
Kuriyama A, Endo K (2017) Goshajinkigan for prevention of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. Support Care Cancer 26(4):1051–1059. https://doi.org/10.1007/s00520-017-4028-6
Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G et al (2017) Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin 67(3):194–232. https://doi.org/10.3322/caac.21397.. PubMed PMID: 28436999
Han X, Wang L, Shi H, Zheng G, He J, Wu W et al (2017) Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma. BMC Cancer 17(1):40. https://doi.org/10.1186/s12885-016-3037-z
Lynch ME, Clark AJ, Sawynok J (2003) A pilot study examining topical amitriptyline, ketamine, and a combination of both in the treatment of neuropathic pain. Clin J Pain 19(5):323–328. https://doi.org/10.1097/00002508-200309000-00007
Barton DL, Wos EJ, Qin R, Mattar BI, Green NB, Lanier KS et al (2010) A double-blind, placebo- controlled trial of a topical treatment for chemotherapy-induced peripheral neuropathy: NCCTG trial N06CA. Support Care Cancer 19(6):833–841. https://doi.org/10.1007/s00520-010-0911-0
Gewandter JS, Mohile SG, Heckler CE, Ryan JL, Kirshner JJ, Flynn PJ et al (2014) A phase III randomized, placebo-controlled study of topical amitriptyline and ketamine for chemotherapy- induced peripheral neuropathy (CIPN): a University of Rochester CCOP study of 462 cancer survivors. Support Care Cancer 22(7):1807–1814. https://doi.org/10.1007/s00520-014-2158-7
Rossignol J, Cozzi B, Liebaert F, Hatton S, Viallard M-L, Hermine O et al (2019) High concentration of topical amitriptyline for treating chemotherapy-induced neuropathies. Support Care Cancer 27(8):3053–3059. https://doi.org/10.1007/s00520-018-4618-y
Anand P, Elsafa E, Privitera R, Naidoo K, Yiangou Y, Donatien P et al (2019) Rational treatment of chemotherapy-induced peripheral neuropathy with capsaicin 8% patch: from pain relief towards disease modification. J Pain Res 12:2039–2052. https://doi.org/10.2147/jpr.s213912
Heydari M, Homayouni K, Hashempur MH, Shams M (2016) Topical Citrullus colocynthis (bitter apple) extract oil in painful diabetic neuropathy: a double-blind randomized placebo-controlled clinical trial. J Diabetes 8(2):246–252. Epub 2015/03/25. PubMed PMID: 25800045. https://doi.org/10.1111/1753-0407.12287
Rostami N, Mosavat SH, Heydarirad G, Arbab Tafti R, Heydari M (2019) Efficacy of topical Citrullus colocynthis (bitter apple) extract oil in chemotherapy-induced peripheral neuropathy: a pilot double-blind randomized placebo-controlled clinical trial. Phytother Res 33(10):2685–2691. Epub 2019/08/03. PubMed PMID: 31373112. https://doi.org/10.1002/ptr.6442
Colvin LA, Johnson PR, Mitchell R, Fleetwood-Walker SM, Fallon M (2008) From bench to bedside: a case of rapid reversal of bortezomib-induced neuropathic pain by the TRPM8 activator, menthol. J Clin Oncol 26(27):4519–4520. Epub 2008/09/20. PubMed PMID: 18802169. https://doi.org/10.1200/JCO.2008.18.5017
Storey DJ, Colvin LA, Mackean MJ, Mitchell R, Fleetwood-Walker SM, Fallon MT (2010) Reversal of dose-limiting carboplatin-induced peripheral neuropathy with TRPM8 activator, menthol, enables further effective chemotherapy delivery. J Pain Symptom Manag 39(6):e2–e4. https://doi.org/10.1016/j.jpainsymman.2010.02.004
Fallon MT, Storey DJ, Krishan A, Weir CJ, Mitchell R, Fleetwood-Walker SM et al (2015) Cancer treatment-related neuropathic pain: proof of concept study with menthol—a TRPM8 agonist. Support Care Cancer 23(9):2769–2777. https://doi.org/10.1007/s00520-015-2642-8
Shahid M, Subhan F, Ahmad N, Sewell RDE (2019) Efficacy of a topical gabapentin gel in a cisplatin paradigm of chemotherapy-induced peripheral neuropathy. BMC Pharmacol Toxicol 20(1):51. https://doi.org/10.1186/s40360-019-0329-3
U.S. National Library of Medicine (2020) ClinicalTrials.gov (August 25, 2020). Available from: https://clinicaltrials.gov/.
Yang YH, Lin JK, Chen WS, Lin TC, Yang SH, Jiang JK et al (2012) Duloxetine improves oxaliplatin- induced neuropathy in patients with colorectal cancer: an open-label pilot study. Support Care Cancer 20(7):1491–1497. https://doi.org/10.1007/s00520-011-1237-2. PubMed PMID: 21814779
Otake A, Yoshino K, Ueda Y, Sawada K, Mabuchi S, Kimura T et al (2015) Usefulness of duloxetine for paclitaxel-induced peripheral neuropathy treatment in gynecological cancer patients. Anticancer Res 35(1):359–363
Kanbayashi Y, Inagaki M, Ueno H, Hosokawa T (2017) Predictors of the usefulness of duloxetine for chemotherapy-induced peripheral neuropathy. Med Oncol 34(8):137. https://doi.org/10.1007/s12032-017-0995-1. PubMed PMID: 28687964
Kus T, Aktas G, Alpak G, Kalender ME, Sevinc A, Kul S et al (2016) Efficacy of venlafaxine for the relief of taxane and oxaliplatin-induced acute neurotoxicity: a single-center retrospective case- control study. Support Care Cancer 24(5):2085–2091. https://doi.org/10.1007/s00520-015-3009-x. PubMed PMID: 26546457
Salehifar E, Janbabaei G, Hendouei N, Alipour A, Tabrizi N, Avan R (2020) Comparison of the efficacy and safety of Pregabalin and duloxetine in Taxane-induced sensory neuropathy: a randomized controlled trial. Clin Drug Investig 40(3):249–257. Epub 2020/01/12. PubMed PMID: 31925721. https://doi.org/10.1007/s40261-019-00882-6
Takenaka M, Iida H, Matsumoto S, Yamaguchi S, Yoshimura N, Miyamoto M (2013) Successful treatment by adding duloxetine to pregabalin for peripheral neuropathy induced by paclitaxel. Am J Hosp Palliat Care 30(7):734–736. https://doi.org/10.1177/1049909112463416. PubMed PMID: 23064035
Battaglini E, Park SB, Barnes EH, Goldstein D (2018) A double blind, placebo controlled, phase II randomised cross-over trial investigating the use of duloxetine for the treatment of chemotherapy- induced peripheral neuropathy. Contemp Clin Trials 70:135–138. https://doi.org/10.1016/j.cct.2018.04.011. PubMed PMID: 29680317
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Mayo, S., Toh, Y.L., Oh, J., Chan, A. (2021). Pharmacological Treatment of Established Chemotherapy-Induced Peripheral Neuropathy. In: Lustberg, M., Loprinzi, C. (eds) Diagnosis, Management and Emerging Strategies for Chemotherapy-Induced Neuropathy. Springer, Cham. https://doi.org/10.1007/978-3-030-78663-2_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-78663-2_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-78662-5
Online ISBN: 978-3-030-78663-2
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)