Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline update

Charles L. Loprinzi, Christina Lacchetti, Jonathan Bleeker, Guido Cavaletti, Cynthia Chauhan, Daniel L. Hertz, Mark R. Kelley, Antoinette Lavino, Maryam B. Lustberg, Judith A. Paice, Bryan P. Schneider, Ellen M. Lavoie Smith, Mary Lou Smith, Thomas J. Smith, Nina Wagner-Johnston, Dawn L. Hershman

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

PURPOSE To update the ASCO guideline on the recommended prevention and treatment approaches in the management of chemotherapy-induced peripheral neuropathy (CIPN) in adult cancer survivors. METHODS An Expert Panel conducted targeted systematic literature reviews to identify new studies. RESULTS The search strategy identified 257 new references, which led to a full-text review of 87 manuscripts. A total of 3 systematic reviews, 2 with meta-analyses, and 28 primary trials for prevention of CIPN in addition to 14 primary trials related to treatment of established CIPN, are included in this update. RECOMMENDATIONS The identified data reconfirmed that no agents are recommended for the prevention of CIPN. The use of acetyl-L-carnitine for the prevention of CIPN in patients with cancer should be discouraged. Furthermore, clinicians should assess the appropriateness of dose delaying, dose reduction, substitutions, or stopping chemotherapy in patients who develop intolerable neuropathy and/or functional impairment. Duloxetine is the only agent that has appropriate evidence to support its use for patients with established painful CIPN. Nonetheless, the amount of benefit from duloxetine is limited.

Original languageEnglish (US)
Pages (from-to)3325-3348
Number of pages24
JournalJournal of Clinical Oncology
Volume38
Issue number28
DOIs
StatePublished - Oct 1 2020

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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