Practice Guideline

. 2020 Oct 1;38(28):3325-3348.

doi: 10.1200/JCO.20.01399. Epub 2020 Jul 14.

Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update

Charles L Loprinzi¹, Christina Lacchetti², Jonathan Bleeker³, Guido Cavaletti⁴, Cynthia Chauhan⁵, Daniel L Hertz⁶, Mark R Kelley⁷, Antoinette Lavino⁸, Maryam B Lustberg⁹, Judith A Paice¹⁰, Bryan P Schneider⁷, Ellen M Lavoie Smith⁶, Mary Lou Smith¹¹, Thomas J Smith¹², Nina Wagner-Johnston¹², Dawn L Hershman¹³

Affiliations

¹ Mayo Clinic, Rochester, MN.
² American Society of Clinical Oncology, Alexandria, VA.
³ Sanford USD Medical Center, Sioux Falls, SD.
⁴ University of Milano-Bicocca, Monza, Italy.
⁵ Wichita, KS.
⁶ University of Michigan, Ann Arbor, MI.
⁷ Indiana University School of Medicine, Indianapolis, IN.
⁸ Mass General North Shore Cancer Center, Danvers, MA.
⁹ Ohio State University, Columbus, OH.
¹⁰ Northwestern University, Chicago, IL.
¹¹ Research Advocacy Network, Plano, TX.
¹² Johns Hopkins, Baltimore, MD.
¹³ Columbia University Medical Center, New York, NY.

PMID: 32663120
DOI: 10.1200/JCO.20.01399

Practice Guideline

Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update

Charles L Loprinzi et al. J Clin Oncol. 2020.

. 2020 Oct 1;38(28):3325-3348.

doi: 10.1200/JCO.20.01399. Epub 2020 Jul 14.

Authors

Affiliations

¹ Mayo Clinic, Rochester, MN.
² American Society of Clinical Oncology, Alexandria, VA.
³ Sanford USD Medical Center, Sioux Falls, SD.
⁴ University of Milano-Bicocca, Monza, Italy.
⁵ Wichita, KS.
⁶ University of Michigan, Ann Arbor, MI.
⁷ Indiana University School of Medicine, Indianapolis, IN.
⁸ Mass General North Shore Cancer Center, Danvers, MA.
⁹ Ohio State University, Columbus, OH.
¹⁰ Northwestern University, Chicago, IL.
¹¹ Research Advocacy Network, Plano, TX.
¹² Johns Hopkins, Baltimore, MD.
¹³ Columbia University Medical Center, New York, NY.

PMID: 32663120
DOI: 10.1200/JCO.20.01399

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.Additional information is available at www.asco.org/survivorship-guidelines.

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Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update

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Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update

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