137: Clinical Profiles and Management of Chemotherapy-Induced Peripheral Neuropathy: A Case Series

Topic: Basic Science
Subtopic: Pain category (ICD-11), Chronic cancer related pain, , , , , , , Neuroimmunology, Pharmacological interventions, Electrophysiology, ,

Background and Aims: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common neurotoxic complications in patients undergoing chemotherapy, with significant implications for quality of life and the continuity of cancer treatment. The variability of clinical manifestations and the limitations of objective diagnostic approaches pose challenges in early detection and optimal management, particularly across different chemotherapy regimens with distinct neurotoxic mechanisms. This study aims to characterize the clinical manifestations and variability of CIPN across different chemotherapy regimens. It further seeks to evaluate treatment responses to commonly used pharmacological therapies. Additionally, the study underscores the importance of early diagnosis and timely intervention to minimize neurological morbidity and preserve treatment continuity.

Methods: This case series describes CIPN in three patients exposed to different chemotherapy regimens. The first case involved a 66-year-old male with diffuse large B-cell lymphoma who developed progressive sensorimotor neuropathy following R-MINI-CHOP therapy. The second case was a 29-year-old male with Hodgkin lymphoma who developed chronic sensory neuropathy after receiving ABVD and BEACOPP regimens. The third case involved a 65-year-old male with stage IV lung adenocarcinoma who developed mild sensory neuropathy following carboplatin–paclitaxel chemotherapy. All patients demonstrated a characteristic clinical pattern of symmetric distal paresthesia, with varying degrees of motor involvement. The diagnosis was established clinically based on chemotherapy exposure history, neuropathic symptoms, and neurological examination findings.

Results: Management included pharmacological therapy with gabapentin and amitriptyline, along with supportive treatment using neurotropic vitamins. Follow-up evaluation showed improvement in neuropathic pain intensity in all cases, although residual sensory symptoms persisted in some patients. Variability in therapeutic response reflects the heterogeneity of the underlying pathophysiological mechanisms of CIPN across different chemotherapy regimens.

Conclusions: This case series highlights CIPN as a heterogeneous clinical entity with variable manifestations and outcomes depending on the type of chemotherapeutic agents and cumulative exposure. Early clinical recognition, the use of standardized assessment tools, and timely therapeutic intervention are essential to minimize neurological morbidity without compromising oncological treatment efficacy.

References: 1. Burgess, J., Ferdousi, M., Gosal, D., Boon, C., Matsumoto, K., Marshall, A., Mak, T., Frank, B., Malik, R.A. dan Alam, U. (2021) ‘Chemotherapy-induced peripheral neuropathy: Epidemiology, pathomechanisms and treatment’, Oncology and Therapy, 9(2), hlm. 385–450. Available at: https://doi.org/10.1007/s40487-021-00168-y
2. Chen, X., Gan, Y., Au, N.P.B. dan Ma, C.H.E. (2024) ‘Current understanding of the molecular mechanisms of chemotherapy-induced peripheral neuropathy’, Frontiers in Molecular Neuroscience, 17, hlm. 1345811. Available at: https://doi.org/10.3389/fnmol.2024.1345811
3. Desforges, A., Hebert, C.M., Spence, A., Bailey, R., Dhaibar, H.A., Cruz-Topete, D., Cornett, E.M., Kaye, A.D., Urits, I. dan Viswanath, O. (2022) ‘Treatment and diagnosis of chemotherapy-induced peripheral neuropathy: An update’, Biomedicine & Pharmacotherapy, 147, hlm. 112671. Available at: https://doi.org/10.1016/j.biopha.2022.112671
4. Tao, Z., Chen, Z., Zeng, X., Cui, J. dan Quan, M. (2024) ‘An emerging aspect of cancer neuroscience: A literature review on chemotherapy-induced peripheral neuropathy’, Cancer Letters, 611, hlm. 217433. Available at: https://doi.org/10.1016/j.canlet.2024.217433
5. Verdugo, R.J., Matamala, J.M., dkk. (2022) ‘Review of techniques useful for the assessment of sensory small-fiber neuropathies: Report from an IFCN expert group’, Clinical Neurophysiology, 133(7), hlm. 1607–1621. Available at: https://doi.org/10.1016/j.clinph.2022.01.002

Presenting Author: Esa Claudia Haning, MD
Submitting Author: Esa Haning

Senior Author: Ida Ayu Sri Wijayanti, MD, PhD

IASP 2026 Global Year theme of Neuropathic Pain: Yes