Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers

Publication Date: July 14, 2020
Last Updated: January 19, 2024

Prevention

Prevention of chemotherapy-induced peripheral neuropathy

Recommendation 1.1

Clinicians should assess the risks and benefits of agents known to cause CIPN among patients with underlying neuropathy and with conditions that predispose to neuropathy such as diabetes and/or a family or personal history of hereditary neuropathy. ( IC , H , H , W )
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Recommendation 1.2

Clinicians should NOT offer, and should discourage use of, acetyl-L-carnitine for the prevention of CIPN in cancer patients. ( EB , I , B , S )
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Recommendation 1.3

Outside the context of a clinical trial, no recommendations can be made on the use of the following interventions for the prevention of CIPN:
  • Acupuncture
  • Cryotherapy
  • Compression therapy
  • Exercise therapy
  • Ganglioside-monosialic acid (GM-1)
(, , , W )
Note: While preliminary evidence suggests a potential for benefit from these interventions, larger sample-sized definitive studies are needed to confirm efficacy and clarify risks.
(No recommendation)
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Recommendation 1.4

Clinicians should NOT offer the following agents for the prevention of CIPN to cancer patients undergoing treatment with neurotoxic agents:
  • All-trans retinoic acid
  • Amifostine
  • Amitriptyline
  • Calcium magnesium
  • Calmangafodipir
  • Cannabinoids
  • Carbamazepine
  • L-carnosine
  • Diethyldithio-carbamate (DDTC)
  • Gabapentin/pregabalin
  • Glutamate
  • Glutathione (GSH) for patients receiving paclitaxel/carboplatin chemotherapy
  • Goshajinkigan (GJG)
  • Metformin
  • Minocycline
  • N-acetylcysteine
  • Nimodipine
  • Omega-3 fatty acids
  • Org 2766
  • Oxcarbazepine
  • rhuLIF
  • Venlafaxine
  • Vitamin B
  • Vitamin E
(EB, NB, M, I)
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Treatment

Treatment of chemotherapy-induced peripheral neuropathy that develops while patients are receiving neurotoxic chemotherapy

Recommendation 2.1

Clinicians should assess, and discuss with patients, the appropriateness of dose delaying, dose reduction or stopping chemotherapy (or substituting with agents that do not cause CIPN) in patients who develop intolerable neuropathy and/or functional nerve impairment. ( IC , H , H , W )
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Overview

Title

Prevention And Management Of Chemotherapy-Induced Peripheral Neuropathy In Survivors Of Adult Cancers

Authoring Organization

American Society of Clinical Oncology