Drug treatment for chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

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  • Sugimoto Mitsuru
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Takagi Tadayuki
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Suzuki Rei
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Konno Naoki
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Asama Hiroyuki
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Sato Yuki
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Irie Hiroki
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Okubo Yoshinori
    Department of Gastroenterology, School of Medicine, Fukushima Medical University Department of Endoscopy, Fukushima Medical University Hospital
  • Nakamura Jun
    Department of Gastroenterology, School of Medicine, Fukushima Medical University Department of Endoscopy, Fukushima Medical University Hospital
  • Takasumi Mika
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Hashimoto Minami
    Department of Gastroenterology, School of Medicine, Fukushima Medical University Department of Endoscopy, Fukushima Medical University Hospital
  • Kato Tsunetaka
    Department of Gastroenterology, School of Medicine, Fukushima Medical University Department of Endoscopy, Fukushima Medical University Hospital
  • Kobashi Ryoichiro
    Department of Gastroenterology, School of Medicine, Fukushima Medical University
  • Hikichi Takuto
    Department of Endoscopy, Fukushima Medical University Hospital
  • Ohira Hiromasa
    Department of Gastroenterology, School of Medicine, Fukushima Medical University

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<p>Pancreatic cancer (PC) is a lethal disease where most tumors are too advanced at diagnosis for resection, leaving chemotherapy as the mainstay of treatment. Although the prognosis of unresectable PC is poor, it has been dramatically improved by new chemotherapy treatments, such as the combination of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin (FOLFIRINOX) or gemcitabine plus nab-paclitaxel. However, as oxaliplatin and paclitaxel are common neurotoxic drugs, chemotherapy-induced peripheral neuropathy (CIPN) is a common and severe adverse effect of both treatments. As there are no agents recommended in the ASCO guidelines, we review the methods used to treat CIPN caused by PC treatment. The efficacy of duloxetine was observed in a large randomized controlled trial (RCT). In addition, pregabalin was more effective than duloxetine for CIPN in two RCTs. Although duloxetine and pregabalin can be effective for CIPN, they have several side effects. Therefore, the choice between the two drugs should be determined according to effect and tolerability. Mirogabalin is also used in patients with PC and there is hope it will yield positive outcomes when treating CIPN in the future.</p>

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