Chemotherapy-Induced Peripheral Neuropathy: Causative Agents, Preventative Strategies, and Treatment Approaches

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a chronic symptom associated with chemotherapy treatment. Symptoms and severity vary based on chemotherapeutic agent used and dose. At present, effective options for the prevention and treatment of CIPN are inadequate and clinical guidance is limited. Unknown mechanism of action, lack of efficacy in many traditional neuropathic pain medications, and inconsistent evidence in regard to drug therapy have further complicated evaluation of therapeutic options. Twenty-five studies were identified and evaluated for CIPN prevention and treatment potential. Findings for CIPN pharmacological prevention were inconclusive as literature was largely conflicting. Exercise may be an effective non-pharmacological CIPN prevention method with limited adverse effects, however additional supporting data is still required. For treatment of CIPN, pharmacological agents duloxetine and topical combination product containing baclofen, amitriptyline, and ketamine have data supporting use. Early stage trials have shown initial promise for non-pharmacological therapies Scrambler Therapy and Photobiomodulation. Significant research is required as CIPN symptoms can lead to decreased quality of life, chemotherapy dose reduction, and discontinuation of drug therapy.

Keywords: CIPN; Chemotherapy; chemotherapy-induced peripheral neuropathy; peripheral neuropathy; prevention; treatment.