From Treatment Methods to Ongoing Research: Everything about Chemotherapy-Induced Peripheral Neuropathy
Chemotherapy-Induced Peripheral Neuropathy or CIPN is a common side effect witnessed among CRC patients. It generally lasts for months or a year. Due to the highly challenging pain caused by the CIPN, some patients stop their chemotherapy treatments altogether. According to a National Cancer Institute (NCI) study, nearly 40% of cancer patients treated with chemotherapy suffer from CIPN. The common symptoms of CIPN include numbness and tingling in hands and feet, sharp electric pain and sudden reduction in sensation to heat or cold, loss of feeling, slow reflexes. In addition, patients become sensitive to touch or pressure and face problems with balance. They also witness difficulty in walking.
Assessment and Diagnosis of CIPN
CIPN generally occur during the initial two months of treatment and increase during the active antineoplastic treatment. However, it stabilizes once the treatment has been completed. The general clinical symptoms of CIPN include predominantly sensory and usually include acral pain and paresthesia together with allodynia and hyperalgesia.
Some Methods to Prevent Chemotherapy-Induced Peripheral Neuropathy (CIPN)
According to the American Cancer Society, no exact method or drugs exist to prevent chemo-induced peripheral neuropathy (CIPN). However, various methods have been diagnosed to help patients manage the symptoms.
There are no 100% effective drugs developed that could prevent CIPN pharmacologically. However, acetyl-L-carnitine, amifostine, amitriptyline, acetylcysteine, α-lipoic acid, calcium/magnesium, carbamazepine, diethyldithiocarbamate, glutathione, Gosha-jinki-gan, omega-3 fatty acids, vitamin B, minocycline, nimodipine, and vitamin E are among a few of the considered drugs for the treatment of peripheral neuropathy. Additionally, steroids can help patients for a short time until an effective long-term plan has been developed.
Patches or creams of numbing medicine, such as lidocaine patches or capsaicin cream, can also be helpful to numb the area of pain.
Antidepressant medicines are often recommended in smaller doses to treat depression. In addition, doctors sometimes recommend anti-seizure medicines to reduce several types of nerve pain and ultimately help the patients. Opioids or narcotics are recommended at the time of severe pain.
Cryotherapy/Compression Therapy is a non-pharmacological form for the prevention of CIPN. Cryotherapy with frozen socks or gloves is considered highly effective.
Some early studies suggest that exercise can be helpful to patients as it helps strengthen their muscles and improve sensorimotor function. In addition, patients are often recommended some particular exercises to relieve the pain. Thus, contact your therapist before beginning your routine exercise.
Tips for dealing with CIPN
Patients are generally recommended few tips to deal with CIPN. Here are some of them listed below:
- First, talk frequently about the symptoms to your doctor or nurse.
- Then, take the medicines as prescribed by your doctor.
- Observe and kindly avoid things that may worsen your CIPN. It generally includes hot or cold temperatures, snug wearables, etc.
- Do things slowly as you used to do before. Ask for help if you find any task difficult. Moreover, cut alcohol from your life as it can result in nerve damage and worsen your CIPN.
- If you have diabetes, work on controlling your high blood sugar levels, damaging your nerves.
- Before thinking about exercise, kindly talk to your doctor or nurse. Your doctor may be able to recommend you helpful exercises for your pain.
- Increase the consumption of fruits and vegetables.
Injury can Worsen the Situation.
Patients often witness the effect of CIPN on their sense of feeling. In that situation, they are more likely to injure themselves, which may worsen the overall situation. Kindly follow these steps to avoid such circumstances.
If you are suffering from neuropathy in your hands, be careful with sharp objects, such as cutters, knives, blades, scissors, etc. You may also protect your hands by wearing gloves whenever you do chores like cleaning, working outdoors, or doing repairs.
For neuropathy in the feet, take proper care of them. Sit most of the time and regularly check if there are any injuries or open sores. Moreover, always cover your feet while walking by wearing shoes. Also, consult your doctor for any additions to enhance the protection.
If you wake up in the night, use a flashlight or other night lights. Also, prevent yourself from head injuries. For cold weather, please keep your hands and feet warm and cover them with a pair of gloves.
Chemotherapy-induced peripheral neuropathy (CIPN) is among the most common side effects caused by antineoplastic agents. According to Astute Analytica, the global 7MM Chemotherapy-Induced Peripheral Neuropathy market is forecast to grow at a compound annual growth rate (CAGR) of 5.16% during the forecast period 2022 to 2030. It is due to the growing geriatric population. In addition, the same source indicates that nearly 30%-40% of patients going through chemotherapy develop CIPN. Furthermore, nearly 1.9 million cancer cases were expected to be diagnosed in 2021, and 608,570 people were expected to die in the United States.
Research activities in this industry as growing at a rapid pace. Due to the growing prevalence of cancer and its side effects, the demand for efficient drugs and therapies increases rapidly. Market players are also carrying out continuous research and introducing innovative strategies to unveil effective patient solutions. For instance, In October 2018, PledPharma started the Phase III of the multicenter, double-blind, placebo-controlled study to develop the efficacious dose of PledOx, which aims to prevent chronic chemotherapy-induced peripheral neuropathy (CIPN) induced by oxaliplatin. This trial included nearly 291 participants and was completed by late 2020.
In December 2019, Solasia Pharma KK inked a licensing agreement with Maruho Co Ltd, a Japan-based pharmaceutical company. This partnership aims to commercialize PledOx for the treatment of CIPN in Japan. In the past, Toray Industries also made headlines for conducting the phase 2 study to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of TRK-750 in Colorectal Cancer Patients. The study was carried out on patients having Chemotherapy-induced Peripheral Neuropathy Following Oxaliplatin-containing Chemotherapy in the Adjuvant Setting.
In 2021, UVM also won a $7M grant for chemotherapy-induced nerve damage treatment, which affects around ¾ of patients. The study is expected to begin in 2022 and enroll around 420 patients. The premise will combine technology and science.