Treatment of chemotherapy-induced peripheral neuropathy that
develops while patients are receiving neurotoxic chemotherapy
Recommendation 2.1
➤ Clinicians should assess, and discuss with patients, the
appropriateness of dose delaying, dose reduction or stopping
chemotherapy (or substituting with agents that do not cause CIPN) in
patients who develop intolerable neuropathy and/or functional nerve
impairment. (Moderate recommendation; IC-B-L)
Treatment of chemotherapy-induced peripheral neuropathy for
patients who have completed neurotoxic chemotherapy
Recommendation 3.1
➤ For cancer patients experiencing painful CIPN, clinicians may offer
duloxetine. (Moderate recommendation; EB-B/H-I)
Recommendation 3.2
➤ Outside the context of a clinical trial, no recommendations can be made
on the use of the following interventions for the treatment of CIPN:
• Exercise therapy
• Acupuncture
• Scrambler therapy
• Gabapentin/pregabalin
• Topical gel treatment containing baclofen, amitriptyline HCL, plus/minus
ketamine
• Tricyclic antidepressants
• Oral cannabinoids
(No recommendation; L)
Note: While recent preliminary evidence suggests a potential for benefit from exercise,
acupuncture, and scrambler therapy, larger sample-sized definitive studies are needed to
confirm efficacy and clarify risks.
Treatment
