Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of both classic and newer chemotherapy agents, affecting 30-40% of cancer patients receiving neurotoxic chemotherapy. CIPN can cause significant costs and reduce quality of life. There are currently no preventive treatments for CIPN, and treatment focuses on reducing or discontinuing the offending chemotherapy agent when CIPN develops, as well as treating neuropathic pain symptoms. More research is still needed to address this challenging complication of cancer treatment.

1. Chemotherapy-Induced
Peripheral Neuropathy
Ade Wijaya, MD – October 2018

2. Peripheral Nueropathies in Cancer Patients
• Chemotherapy-induced peripheral neuropathy (CIPN)
• Paraneoplastic neuropathies
• Immune-mediated neuropathies
• Neoplastic neuropathies
Pike CT, Birnbaum HG, Muehlenbein CE, Pohl GM, Natale RB. Healthcare costs and workloss burden of patients with chemotherapy-associated peripheral neuropathy in breast, ovarian, head and neck, and
nonsmall cell lung cancer. Chemother Res Pract. 2012;2012:913848

3. Introduction
• 30–40% of patients receiving neurotoxic chemotherapy
• Both classic and newer agents
• Cost and QOL
Pike CT, Birnbaum HG, Muehlenbein CE, Pohl GM, Natale RB. Healthcare costs and workloss burden of patients with chemotherapy-associated peripheral neuropathy in breast, ovarian, head and neck, and
nonsmall cell lung cancer. Chemother Res Pract. 2012;2012:913848

4. Staff NP, Grisold A, Grisold W, Windebank AJ. Chemotherapy‐induced peripheral neuropathy: A current review. Annals of neurology. 2017 Jun;81(6):772-81.

5. Argyriou AA, Kyritsis AP, Makatsoris T, Kalofonos HP. Chemotherapy-induced peripheral neuropathy in adults: a comprehensive update of the literature. Cancer management and research. 2014;6:135.

6. Argyriou AA, Kyritsis AP, Makatsoris T, Kalofonos HP. Chemotherapy-induced peripheral neuropathy in adults: a comprehensive update of the literature. Cancer management and research. 2014;6:135.

7. Argyriou AA, Kyritsis AP, Makatsoris T, Kalofonos HP. Chemotherapy-induced peripheral neuropathy in adults: a comprehensive update of the literature. Cancer management and research. 2014;6:135.

8. Treatment
• No preventive treatments
• Reducing or discontinuing the offending agent when CIPN develops and
treating the symptoms of neuropathic pain.
• Neurorehabilitation
Majithia N, Temkin SM, Ruddy KJ, Beutler AS, Hershman DL, Loprinzi CL. National Cancer Institute-supported chemotherapy-induced peripheral neuropathy trials: outcomes and
lessons. Support Care Cancer. 2016 Mar;24(3):1439–47.
Stubblefield MD, McNeely ML, Alfano CM, Mayer DK. A prospective surveillance model for physical rehabilitation of women with breast cancer: chemotherapy-induced peripheral neuropathy. Cancer.2012;118(Suppl 8):2250–2260.

9. Summary
• Cancers nowadays have better survival rate  CIPN more prevalent
• Cost and QOL
• Both classic and newer agents
• No preventive agents
• Future researches

10. THANK YOU