Pharmacotherapy options for managing chemotherapy-induced peripheral neurotoxicity.

INTRODUCTION: Prevention and treatment of chemotherapy-induced peripheral neurotoxicity (CIPN) are clinically-relevant unmet needs. Despite extensive efforts at the preclinical and clinical levels, no effective pharmacological interventions are available, and this unsatisfactory situation reflects a combination of methodological issues and a lack of effectiveness of the tested drugs. AREAS COVERED: This non-systematic, but unbiased review is based on published papers available in PubMed and screened using the broad search string [chemotherapy (and) neuropathy (and) treatment] to analyze the reported data. Subsequently, the same search was performed in ClinicalTrials.gov to assess the trend of new clinical studies. EXPERT OPINION: From the analysis of the most recently published clinical studies and of the ongoing registered trials it seems that drug-based treatment attempts are being overwhelmed by non-pharmacological studies, in most cases based on weak supporting hypothesis. Among the possible strategies important to restore a prominent role for drug-based clinical trials, increased knowledge on CIPN pathophysiology, more effective translation of preclinical results into clinical setting, improvement in CIPN assessment and the identification of subjects at high-risk for more severe CIPN are important areas to concentrate investigational efforts.