ABSTRACT
Introduction: Prevention and treatment of chemotherapy-induced peripheral neurotoxicity (CIPN) are clinically-relevant unmet needs. Despite extensive efforts at the preclinical and clinical levels, no effective pharmacological interventions are available, and this unsatisfactory situation reflects a combination of methodological issues and a lack of effectiveness of the tested drugs.
Areas covered: This non-systematic, but unbiased review is based on published papers available in PubMed and screened using the broad search string [chemotherapy (and) neuropathy (and) treatment] to analyze the reported data. Subsequently, the same search was performed in ClinicalTrials.gov to assess the trend of new clinical studies.
Expert opinion: From the analysis of the most recently published clinical studies and of the ongoing registered trials it seems that drug-based treatment attempts are being overwhelmed by non-pharmacological studies, in most cases based on weak supporting hypothesis. Among the possible strategies important to restore a prominent role for drug-based clinical trials, increased knowledge on CIPN pathophysiology, more effective translation of preclinical results into clinical setting, improvement in CIPN assessment and the identification of subjects at high-risk for more severe CIPN are important areas to concentrate investigational efforts.
Article highlights
Chemotherapy-Induced Peripheral Neurotoxicity (CIPN) treatment is a clinically-relevant, unmet need
There is not a general consensus regarding the optimal way to assess CIPN occurrence and severity
Recently, the number of non-pharmacological trials is increasing while conventional, drug-based trials are very few
This effect is probably not only related to a lack of efficacy, but also to sub-optimal clinical investigation
Reflection on possible new, different endpoints and study design in CIPN prevention trials is warranted
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Declaration of interest
The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.