A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy

Alisha Joan Leen; Dominic Wei Ting Yap; Chong Boon Teo; Benjamin Kye Jyn Tan; Alex Molassiotis; Hiroshi Ishiguro; Sarah Wei Xian Fan; Raghav Sundar; Yu Yang Soon; Aishwarya Bandla

doi:10.3389/fonc.2021.763229

A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy

Alisha Joan Leen
, Dominic Wei Ting Yap
, Chong Boon Teo
, Benjamin Kye Jyn Tan
, Alex Molassiotis
, Hiroshi Ishiguro
, Sarah Wei Xian Fan
, Raghav Sundar^*
, Yu Yang Soon^*
, Aishwarya Bandla^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

18 Citations (Scopus)

1 Downloads (Pure)

Abstract

Background: Paclitaxel-induced peripheral neuropathy (PIPN) is a disabling side effect of paclitaxel with few effective preventive strategies. We aim to determine the efficacy of pharmacological and non-pharmacological neuroprotective interventions in preventing PIPN incidence. Methods: Biomedical literature databases were searched from years 2000 to 2021 for trials comparing neuroprotective interventions and control. Meta-analysis was performed using the random-effects model. The primary outcome was the incidence of PIPN. Results: Of 24 relevant controlled trials, 14 were eligible for meta-analysis. Pooled results from seven non-pharmacological trials were associated with a statistically significant 48% relative reduction of PIPN risk with low heterogeneity. Conversely, pooled results from six pharmacological trials were associated with a significant 20% relative reduction of PIPN risk with moderate heterogeneity. Both pharmacological and non-pharmacological approaches appear effective in reducing PIPN incidence in the treatment arm compared to control (pooled RR < 1). Conclusion: Current evidence suggests that both interventions may reduce PIPN risk. Non-pharmacological interventions appear more effective than pharmacological interventions.

Original language	English
Article number	763229
Number of pages	15
Journal	Frontiers in Oncology
Volume	11
DOIs	https://doi.org/10.3389/fonc.2021.763229
Publication status	Published - 5 Jan 2022

Bibliographical note

Copyright © 2022 Leen, Yap, Teo, Tan, Molassiotis, Ishiguro, Fan, Sundar, Soon and Bandla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Data Access Statement

The original contributions presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding authors.

Funding

This work was supported by the National Medical Research Council under its Clinician Scientist—Individual Research Grant (NMRC/CNIG/1167/2017); the National University Health System under its NUHS Summit Research Program—Cancer (NCSP N-171-000-493-001); and the National University of Singapore under its N.1 Institute for Health’s Translational Core.

Keywords

chemotherapy-induced peripheral neuropathy (CIPN)
neuroprotection
non-invasive
paclitaxel-induced peripheral neuropathy
prevention
taxane

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10.3389/fonc.2021.763229Licence: CC BY 4.0

A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy
Copyright © 2022 Leen, Yap, Teo, Tan, Molassiotis, Ishiguro, Fan, Sundar, Soon and Bandla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Final published version, 4.44 MBLicence: CC BY 4.0

Cite this

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title = "A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy",

abstract = "Background: Paclitaxel-induced peripheral neuropathy (PIPN) is a disabling side effect of paclitaxel with few effective preventive strategies. We aim to determine the efficacy of pharmacological and non-pharmacological neuroprotective interventions in preventing PIPN incidence. Methods: Biomedical literature databases were searched from years 2000 to 2021 for trials comparing neuroprotective interventions and control. Meta-analysis was performed using the random-effects model. The primary outcome was the incidence of PIPN. Results: Of 24 relevant controlled trials, 14 were eligible for meta-analysis. Pooled results from seven non-pharmacological trials were associated with a statistically significant 48\% relative reduction of PIPN risk with low heterogeneity. Conversely, pooled results from six pharmacological trials were associated with a significant 20\% relative reduction of PIPN risk with moderate heterogeneity. Both pharmacological and non-pharmacological approaches appear effective in reducing PIPN incidence in the treatment arm compared to control (pooled RR < 1). Conclusion: Current evidence suggests that both interventions may reduce PIPN risk. Non-pharmacological interventions appear more effective than pharmacological interventions.",

keywords = "chemotherapy-induced peripheral neuropathy (CIPN), neuroprotection, non-invasive, paclitaxel-induced peripheral neuropathy, prevention, taxane",

author = "Leen, \{Alisha Joan\} and Yap, \{Dominic Wei Ting\} and Teo, \{Chong Boon\} and Tan, \{Benjamin Kye Jyn\} and Alex Molassiotis and Hiroshi Ishiguro and Fan, \{Sarah Wei Xian\} and Raghav Sundar and Soon, \{Yu Yang\} and Aishwarya Bandla",

note = "Copyright {\textcopyright} 2022 Leen, Yap, Teo, Tan, Molassiotis, Ishiguro, Fan, Sundar, Soon and Bandla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.",

year = "2022",

month = jan,

day = "5",

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AU - Leen, Alisha Joan

AU - Yap, Dominic Wei Ting

AU - Teo, Chong Boon

AU - Tan, Benjamin Kye Jyn

AU - Molassiotis, Alex

AU - Ishiguro, Hiroshi

AU - Fan, Sarah Wei Xian

AU - Sundar, Raghav

AU - Soon, Yu Yang

AU - Bandla, Aishwarya

N1 - Copyright © 2022 Leen, Yap, Teo, Tan, Molassiotis, Ishiguro, Fan, Sundar, Soon and Bandla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

PY - 2022/1/5

Y1 - 2022/1/5

N2 - Background: Paclitaxel-induced peripheral neuropathy (PIPN) is a disabling side effect of paclitaxel with few effective preventive strategies. We aim to determine the efficacy of pharmacological and non-pharmacological neuroprotective interventions in preventing PIPN incidence. Methods: Biomedical literature databases were searched from years 2000 to 2021 for trials comparing neuroprotective interventions and control. Meta-analysis was performed using the random-effects model. The primary outcome was the incidence of PIPN. Results: Of 24 relevant controlled trials, 14 were eligible for meta-analysis. Pooled results from seven non-pharmacological trials were associated with a statistically significant 48% relative reduction of PIPN risk with low heterogeneity. Conversely, pooled results from six pharmacological trials were associated with a significant 20% relative reduction of PIPN risk with moderate heterogeneity. Both pharmacological and non-pharmacological approaches appear effective in reducing PIPN incidence in the treatment arm compared to control (pooled RR < 1). Conclusion: Current evidence suggests that both interventions may reduce PIPN risk. Non-pharmacological interventions appear more effective than pharmacological interventions.

AB - Background: Paclitaxel-induced peripheral neuropathy (PIPN) is a disabling side effect of paclitaxel with few effective preventive strategies. We aim to determine the efficacy of pharmacological and non-pharmacological neuroprotective interventions in preventing PIPN incidence. Methods: Biomedical literature databases were searched from years 2000 to 2021 for trials comparing neuroprotective interventions and control. Meta-analysis was performed using the random-effects model. The primary outcome was the incidence of PIPN. Results: Of 24 relevant controlled trials, 14 were eligible for meta-analysis. Pooled results from seven non-pharmacological trials were associated with a statistically significant 48% relative reduction of PIPN risk with low heterogeneity. Conversely, pooled results from six pharmacological trials were associated with a significant 20% relative reduction of PIPN risk with moderate heterogeneity. Both pharmacological and non-pharmacological approaches appear effective in reducing PIPN incidence in the treatment arm compared to control (pooled RR < 1). Conclusion: Current evidence suggests that both interventions may reduce PIPN risk. Non-pharmacological interventions appear more effective than pharmacological interventions.

KW - chemotherapy-induced peripheral neuropathy (CIPN)

KW - neuroprotection

KW - non-invasive

KW - paclitaxel-induced peripheral neuropathy

KW - prevention

KW - taxane

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DO - 10.3389/fonc.2021.763229

M3 - Review article

AN - SCOPUS:85123244835

SN - 2234-943X

VL - 11

JO - Frontiers in Oncology

JF - Frontiers in Oncology

M1 - 763229

ER -

A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy

Abstract

Bibliographical note

Data Access Statement

Funding

Keywords

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