title: National Cancer Institute-supported chemotherapy-induced peripheral neuropathy trials: outcomes and lessons.
abstract: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and debilitating complications of cancer treatment. Due to a lack of effective management options for patients with CIPN, the National Cancer Institute (NCI) sponsored a series of trials aimed at both prevention and treatment. A total of 15 such studies were approved, evaluating use of various neuro-modulatory agents which have shown benefit in other neuropathic pain states. Aside from duloxetine, none of the pharmacologic methods demonstrated therapeutic benefit for patients with CIPN. Despite these disappointing results, the series of trials revealed important lessons that have informed subsequent work. Some examples of this include the use of patient-reported symptom metrics, the elimination of traditional--yet unsubstantiated--practice approaches, and the discovery of molecular genetic predictors of neuropathy. Current inquiry is being guided by the results from these large-scale trials, and as such, stands better chance of identifying durable solutions for this treatment-limiting toxicity.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. majithia.neil@mayo.edu.
authors.forename: Neil
authors.initials: N
authors.lastname: Majithia
authors.affiliation: Community Oncology and Prevention Trials Research Group, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Temkin
authors.affiliation: Department of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Ruddy
authors.affiliation: Department of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Andreas S
authors.initials: AS
authors.lastname: Beutler
authors.affiliation: Department of Medicine, Department of Epidemiology, Mailman School of Public Health, Columbia University College of Physicians and Surgeons, Herbert Irving Comprehensive Cancer Center, Columbia University, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, 161 Fort Washington Ave #1068, New York, NY, 10032, USA.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.affiliation: Department of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D054547:National Cancer Institute (U.S.); D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D016896:Treatment Outcome; D014481:United States
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; Chemotherapy; Clinical trials; Peripheral neuropathy