Four in Ten Chemotherapy-Treated Patients Have Chronic Peripheral Neuropathy

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Four in Ten Chemotherapy-Treated Patients Have Chronic Peripheral Neuropathy


Four in Ten Chemotherapy-Treated Patients Have Chronic Peripheral Neuropathy
Credit: Aleksei Morozov / iStock / Getty Images Plus

New research has provided an extensive global prevalence estimate of chemotherapy-induced peripheral neuropathy (CIPN), and the number is extraordinary. A comprehensive study conducted by the Mayo Clinic examined 10,962 patients from 28 different countries to demonstrate the significant impact of CIPN. This distressing condition is brought on by neurotoxic chemotherapeutic drugs and causes motor and sensory disturbances such as tingling, numbness, and pain in a symmetrical, stocking-glove pattern. This finding, along with the fact that CIPN prevalence differs by region, chemotherapy regimen, and primary cancer type, highlights the importance of individually tailored pain management programs and the necessity for additional research into the factors that impact CIPN prevalence in patient care.

Painful chemotherapy-induced peripheral neuropathy

Many patients do not experience painful CIPN symptoms, but those who do face significant limitations in their daily lives, a worse quality of life, and financial struggles. Treatment outcomes and survival rates can be impacted when chemotherapy is reduced or discontinued entirely as a result of severe cases. Although CIPN is important in clinical practice, little is known about the mechanisms that cause painful CIPN. These processes may have neurotoxic effects, such as damage to mitochondria, dysfunction of ion channels, and inflammation of the nervous system.

Managing painful CIPN is currently a challenge due to the lack of preventive strategies and the scarcity of effective treatments. The incidence and severity of CIPN can be influenced by factors like cumulative dosage, pre-existing neuropathy, and certain types of chemotherapy. It may still be necessary to stop chemotherapy in severe cases, even with multimodal approaches. While estimates put the prevalence of CIPN at 70% in the first month of treatment, the frequency of painful CIPN is unclear.

Limited and varied pain treatments

This study is the first meta-analysis to provide comprehensive global prevalence estimates of chronic painful CIPN, addressing a critical gap in the literature. To fill this informational void, researchers conducted this meta-analysis to examine demographics, chemotherapy treatments, and research methods concerning the worldwide incidence of chronic painful CIPN from 2000–2024.

Results from 77 trials, including 10,962 patients from 28 countries, showed a pooled prevalence of chronic painful CIPN of 41.22%. Asia had the highest prevalence (46.52%), while Europe had the lowest (35.92%). The rates associated with platinum-based agents and taxanes (mitotic inhibitors) were 40.44% and 38.35%, respectively. Lung cancer patients had the highest prevalence (62.26%), while ovarian cancer and lymphoma had the lowest (31.40% and 35.98%).

The future of pain treatment

Given the variety of cancers and chemotherapy drugs, scientists must conduct mechanistic studies to determine how these treatments affect sensory neurons. Despite the significant burden of chronic painful CIPN, prevalence rates have remained stable, reflecting limited advancements in treatment. The reliance on potent neurotoxic agents and the unclear role of opioids in managing chronic pain post-cancer remission add to the challenges. Furthermore, no neuromodulation therapies have been FDA-approved for CIPN, highlighting an urgent need for innovative therapeutic approaches to address this debilitating condition effectively.

Additionally, the significant prevalence and variability of chronic painful CIPN across regions underscore the necessity for extensive, multinational studies to encompass diverse populations, especially from underrepresented areas such as Africa, Asia, and South America. These studies could clarify global prevalence and identify regional factors influencing outcomes, such as genetic susceptibility and healthcare quality.



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