Chemotherapy-Induced Peripheral Neuropathy: Prevention and Treatment

Chemotherapy‐induced peripheral neuropathy (CIPN) is a common, dose‐limiting side effect of many chemotherapeutic agents. Although many therapies have been investigated for the prevention and/or treatment of CIPN, there is no well‐accepted proven therapy. In addition, there is no universally accepte...

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Bibliographic Details
Published in:Clinical pharmacology and therapeutics 2011-09, Vol.90 (3), p.377-387
Main Authors: Pachman, D R, Barton, D L, Watson, J C, Loprinzi, C L
Format: Article
Language:English
Subjects:
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Biological and medical sciences
Humans
Medical sciences
Pain - chemically induced
Pain - drug therapy
Pain - prevention & control
Peripheral Nervous System Diseases - chemically induced
Peripheral Nervous System Diseases - drug therapy
Peripheral Nervous System Diseases - physiopathology
Peripheral Nervous System Diseases - prevention & control
Pharmacology. Drug treatments
Treatment Outcome
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Summary:Chemotherapy‐induced peripheral neuropathy (CIPN) is a common, dose‐limiting side effect of many chemotherapeutic agents. Although many therapies have been investigated for the prevention and/or treatment of CIPN, there is no well‐accepted proven therapy. In addition, there is no universally accepted, well‐validated measure for the assessment of CIPN. The agents for which there are the strongest preliminary data regarding their potential efficacy in preventing CIPN are intravenous calcium and magnesium (Ca/Mg) infusions and glutathione. Agents with the strongest supporting evidence for efficacy in the treatment of CIPN include topical pain relievers, such as baclofen/amitriptyline/ketamine gel, and serotonin and norepinephrine reuptake inhibitors, such as venlafaxine and duloxetine. Other promising therapies are also reviewed in this paper. Cutaneous electrostimulation is a nonpharmacological therapy that appears, from an early pilot trial, to be potentially effective in the treatment of CIPN. Finally, there is a lack of evidence of effective treatments for the paclitaxel acute pain syndrome (P‐APS), which appears to be caused by neurologic injury. Clinical Pharmacology & Therapeutics (2011) 90 3, 377–387. doi:10.1038/clpt.2011.115
ISSN:0009-9236
1532-6535
DOI:10.1038/clpt.2011.115