Limb Hypothermia for Preventing Paclitaxel-Induced Peripheral Neuropathy in Breast Cancer Patients: A Pilot Study

Area of Science:

• Oncology
• Neurology
• Medical Devices

Background:

• Paclitaxel chemotherapy commonly causes dose-limiting peripheral neuropathy (PN).
• Currently, no effective prevention or treatment exists for paclitaxel-induced PN.
• Continuous-flow limb hypothermia is hypothesized to mitigate this toxicity.

Purpose of the Study:

• To investigate the neuroprotective effect of continuous-flow limb hypothermia.
• To assess the safety and tolerability of limb hypothermia during paclitaxel infusion.
• To evaluate the impact of hypothermia on paclitaxel-induced peripheral neuropathy.

Main Methods:

• An internally controlled pilot trial was conducted.
• Breast cancer patients received weekly paclitaxel with one limb undergoing hypothermia.
• Nerve conduction studies (NCSs) assessed PN; skin temperature and tolerability were monitored.

Main Results:

• Continuous-flow limb hypothermia (22°C) was well tolerated in 20 patients over 218 cycles.
• Mean skin temperature reduction was 1.5°C; no treatment interruptions occurred.
• Grade 3 PN occurred in 10% of patients; significant correlation between cooling and motor nerve amplitude preservation was noted.

Conclusions:

• Continuous limb hypothermia may reduce paclitaxel-induced PN.
• The method is safe, well-tolerated, and shows therapeutic potential in select patients.
• Further investigation into limb hypothermia for PN prevention is warranted.