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