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

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 )

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

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 )

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)

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 )