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Chemotherapy‐induced peripheral neuropathy: Identifying the research gaps and associated changes to clinical trial design
Author(s) -
St. Germain Diane C.,
O’Mara Ann M.,
Robinson Jennifer L.,
Torres Andrea D.,
Minasian Lori M.
Publication year - 2020
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.33108
Subject(s) - chemotherapy induced peripheral neuropathy , medicine , psychological intervention , clinical trial , intervention (counseling) , medline , alternative medicine , randomized controlled trial , intensive care medicine , peripheral neuropathy , psychiatry , surgery , pathology , endocrinology , political science , law , diabetes mellitus
Background To the authors' knowledge, the empiric identification of agents and interventions to mitigate chemotherapy‐induced peripheral neuropathy (CIPN) has resulted in only 1 agent that modestly mitigates it and no agents or interventions that prevent its development. This speaks to the need for a mechanistic understanding of CIPN to develop effective interventions. Methods To understand the extent to which mechanistic understanding of CIPN is being translated into the development of interventions, the National Cancer Institute conducted a review of the National Institutes of Health (NIH)'s portfolio of investigator‐initiated grants, the literature regarding CIPN mechanisms, and the clinical trials listed in the ClinicalTrials.gov database from January 1, 2011, to May 22, 2019. Results A total of 69 NIH‐supported grants and 95 published articles were identified that evaluated mechanistic pathways of 7 different chemotherapy agents that cause CIPN. The review also identified 35 clinical trials that investigated agents or devices with which to treat CIPN. Only 3 trials incorporated a mechanistic rationale to support the choice of the intervention. Conclusions To the authors' knowledge, very little of the mechanistic understanding of the development of CIPN is being translated into intervention rationale in clinical trials that evaluate interventions to mitigate CIPN. Efforts to incentivize this translation are needed.