Recent advances in managing chemotherapy-induced peripheral neuropathy: A systematic review

Purpose: The aim in this review was to explore recent advances in chemotherapy-induced peripheral neuropathy (CIPN) management interventions and to identify the implications for practice and future research.

Methods: A comprehensive search through seven electronic databases (AMED, CINAHL, Cochrane Library, EMBASE, PEDro, PubMed, and Web of Science) was conducted for studies published between January 1, 2013 and August 3, 2019. An updated search for subsequently published studies was made through PubMed on February 15, 2022. Randomized controlled trials (RCTs) involving either pharmacological or non-pharmacological interventions were considered eligible. The Cochrane Risk of Bias tool version 2.0 (RoB 2.0) was used to appraise the methodological risk of bias. Data extracted from the included RCTs were synthesized in a narrative approach.

Results: Forty-two RCTs involving a total of 3393 participants were included. Overall, a high risk of bias was found in most of the included RCTs. The results further confirmed the analgesic effect of duloxetine on pain-related to CIPN. Exercise-based interventions, acupuncture, and several non-invasive neuromodulation techniques showed promise for managing CIPN.

Conclusions: The effects of most pharmacological and non-pharmacological interventions on CIPN are inconclusive due to methodological issues. Duloxetine remains the only pharmacological intervention recommended for managing pain related to CIPN. Although definitive recommendations cannot be made based on current research evidence, non-pharmacological interventions, especially non-invasive neuromodulation techniques, warrant future research.