Current use of drugs affecting the central nervous system for chemotherapy-induced peripheral neuropathy in cancer patients: a systematic review

Sang Hui Chu, Young Joo Lee, Eon Sook Lee, Yimin Geng, Xin Shelley Wang, Charles S. Cleeland

Research output: Contribution to journalReview article

19 Citations (Scopus)

Abstract

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is common among cancer patients who undergo chemotherapy with platinum analogues, taxanes, vinca alkaloids, epothilone, bortezomib, and thalidomide. The purpose of this study was to investigate the evidence of using drugs affecting the central nervous system (CNS) to alleviate CIPN in cancer patients.

Methods: A systematic literature search was conducted using the CINAHL, EMBASE, and Medline databases to identify randomized controlled clinical trials (RCTs) reported in English up to 2013. We identified ten trials of CNS-acting drugs used to treat CIPN in cancer patients and reviewed efficacy and safety of CNS-acting drugs for CIPN using a standard data collection form. The risk of bias in each RCT was also assessed.

Results: Antidepressants were used in six studies and anticonvulsants in four studies. We found positive results for amitriptyline (topical), venlafaxine, and oxcarbazepine in one study each, but the results were not sufficient to draw definite conclusions. One trial with duloxetine showed a moderate effect (effect size, 0.513, P =.003) on CIPN pain relief. However, none of the results has yet been duplicated in an RCT with a large sample size.

Conclusions: Insufficient RCTs exist to confirm the efficacy of CNS agents to reduce CIPN. This study highlighted the need for and the importance of conducting well-designed RCTs to generate evidence on CIPN symptom management. Additional RCTs are warranted to accelerate the potential use of CNS drugs for CIPN in cancer patients.

Original languageEnglish
Pages (from-to)513-524
Number of pages12
JournalSupportive Care in Cancer
Volume23
Issue number2
DOIs
Publication statusPublished - 2015 Jan 1

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Central Nervous System Agents
Peripheral Nervous System Diseases
Drug Therapy
Randomized Controlled Trials
Neoplasms
Epothilones
Vinca Alkaloids
Taxoids
Amitriptyline
Thalidomide
Platinum
Anticonvulsants
Sample Size
Antidepressive Agents
Databases
Safety
Pain

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Chu, Sang Hui ; Lee, Young Joo ; Lee, Eon Sook ; Geng, Yimin ; Wang, Xin Shelley ; Cleeland, Charles S. / Current use of drugs affecting the central nervous system for chemotherapy-induced peripheral neuropathy in cancer patients : a systematic review. In: Supportive Care in Cancer. 2015 ; Vol. 23, No. 2. pp. 513-524.
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abstract = "Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is common among cancer patients who undergo chemotherapy with platinum analogues, taxanes, vinca alkaloids, epothilone, bortezomib, and thalidomide. The purpose of this study was to investigate the evidence of using drugs affecting the central nervous system (CNS) to alleviate CIPN in cancer patients.Methods: A systematic literature search was conducted using the CINAHL, EMBASE, and Medline databases to identify randomized controlled clinical trials (RCTs) reported in English up to 2013. We identified ten trials of CNS-acting drugs used to treat CIPN in cancer patients and reviewed efficacy and safety of CNS-acting drugs for CIPN using a standard data collection form. The risk of bias in each RCT was also assessed.Results: Antidepressants were used in six studies and anticonvulsants in four studies. We found positive results for amitriptyline (topical), venlafaxine, and oxcarbazepine in one study each, but the results were not sufficient to draw definite conclusions. One trial with duloxetine showed a moderate effect (effect size, 0.513, P =.003) on CIPN pain relief. However, none of the results has yet been duplicated in an RCT with a large sample size.Conclusions: Insufficient RCTs exist to confirm the efficacy of CNS agents to reduce CIPN. This study highlighted the need for and the importance of conducting well-designed RCTs to generate evidence on CIPN symptom management. Additional RCTs are warranted to accelerate the potential use of CNS drugs for CIPN in cancer patients.",
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Current use of drugs affecting the central nervous system for chemotherapy-induced peripheral neuropathy in cancer patients : a systematic review. / Chu, Sang Hui; Lee, Young Joo; Lee, Eon Sook; Geng, Yimin; Wang, Xin Shelley; Cleeland, Charles S.

In: Supportive Care in Cancer, Vol. 23, No. 2, 01.01.2015, p. 513-524.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Current use of drugs affecting the central nervous system for chemotherapy-induced peripheral neuropathy in cancer patients

T2 - a systematic review

AU - Chu, Sang Hui

AU - Lee, Young Joo

AU - Lee, Eon Sook

AU - Geng, Yimin

AU - Wang, Xin Shelley

AU - Cleeland, Charles S.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is common among cancer patients who undergo chemotherapy with platinum analogues, taxanes, vinca alkaloids, epothilone, bortezomib, and thalidomide. The purpose of this study was to investigate the evidence of using drugs affecting the central nervous system (CNS) to alleviate CIPN in cancer patients.Methods: A systematic literature search was conducted using the CINAHL, EMBASE, and Medline databases to identify randomized controlled clinical trials (RCTs) reported in English up to 2013. We identified ten trials of CNS-acting drugs used to treat CIPN in cancer patients and reviewed efficacy and safety of CNS-acting drugs for CIPN using a standard data collection form. The risk of bias in each RCT was also assessed.Results: Antidepressants were used in six studies and anticonvulsants in four studies. We found positive results for amitriptyline (topical), venlafaxine, and oxcarbazepine in one study each, but the results were not sufficient to draw definite conclusions. One trial with duloxetine showed a moderate effect (effect size, 0.513, P =.003) on CIPN pain relief. However, none of the results has yet been duplicated in an RCT with a large sample size.Conclusions: Insufficient RCTs exist to confirm the efficacy of CNS agents to reduce CIPN. This study highlighted the need for and the importance of conducting well-designed RCTs to generate evidence on CIPN symptom management. Additional RCTs are warranted to accelerate the potential use of CNS drugs for CIPN in cancer patients.

AB - Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is common among cancer patients who undergo chemotherapy with platinum analogues, taxanes, vinca alkaloids, epothilone, bortezomib, and thalidomide. The purpose of this study was to investigate the evidence of using drugs affecting the central nervous system (CNS) to alleviate CIPN in cancer patients.Methods: A systematic literature search was conducted using the CINAHL, EMBASE, and Medline databases to identify randomized controlled clinical trials (RCTs) reported in English up to 2013. We identified ten trials of CNS-acting drugs used to treat CIPN in cancer patients and reviewed efficacy and safety of CNS-acting drugs for CIPN using a standard data collection form. The risk of bias in each RCT was also assessed.Results: Antidepressants were used in six studies and anticonvulsants in four studies. We found positive results for amitriptyline (topical), venlafaxine, and oxcarbazepine in one study each, but the results were not sufficient to draw definite conclusions. One trial with duloxetine showed a moderate effect (effect size, 0.513, P =.003) on CIPN pain relief. However, none of the results has yet been duplicated in an RCT with a large sample size.Conclusions: Insufficient RCTs exist to confirm the efficacy of CNS agents to reduce CIPN. This study highlighted the need for and the importance of conducting well-designed RCTs to generate evidence on CIPN symptom management. Additional RCTs are warranted to accelerate the potential use of CNS drugs for CIPN in cancer patients.

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U2 - 10.1007/s00520-014-2408-8

DO - 10.1007/s00520-014-2408-8

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JO - Supportive Care in Cancer

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