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.
Abstract/References
Drug treatment for chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Yoshinori Okubo, Jun Nakamura, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Ryoichiro Kobashi, Takuto Hikichi, Hiromasa Ohira
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Mitsuru Sugimoto
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Tadayuki Takagi
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Rei Suzuki
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Naoki Konno
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Hiroyuki Asama
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Yuki Sato
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Hiroki Irie
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Yoshinori Okubo
Department of Gastroenterology, School of Medicine, Fukushima Medical University
Department of Endoscopy, Fukushima Medical University Hospital
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Jun Nakamura
Department of Gastroenterology, School of Medicine, Fukushima Medical University
Department of Endoscopy, Fukushima Medical University Hospital
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Mika Takasumi
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Minami Hashimoto
Department of Gastroenterology, School of Medicine, Fukushima Medical University
Department of Endoscopy, Fukushima Medical University Hospital
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Tsunetaka Kato
Department of Gastroenterology, School of Medicine, Fukushima Medical University
Department of Endoscopy, Fukushima Medical University Hospital
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Ryoichiro Kobashi
Department of Gastroenterology, School of Medicine, Fukushima Medical University
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Takuto Hikichi
Department of Endoscopy, Fukushima Medical University Hospital
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Hiromasa Ohira
Department of Gastroenterology, School of Medicine, Fukushima Medical University
Abstract
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