Repurposing chemotherapy-induced peripheral neuropathy grading

Area of Science:

• Neuroscience
• Oncology
• Clinical Pharmacology

Background:

• Chemotherapy-induced peripheral neuropathy (CIPN) presents a challenge in clinical practice due to discrepancies between patient-reported symptoms and physician assessments.
• Current recommendations for CIPN assessment involve integrating clinical evaluations with patient-reported outcomes, which can be difficult to implement effectively.

Purpose of the Study:

• To bridge the gap between patient perceptions and objective neurological impairments in CIPN.
• To align patient and physician perspectives on CIPN severity to improve treatment decision-making.

Main Methods:

• Pooled data from 372 subjects with established CIPN from two prospective studies.
• Assessed patient and physician views using NCI-CTCAE, TNSc, and EORTC QLQ-CIPN20.
• Employed hierarchical cluster analysis (k-means) and discriminant functional analysis to identify neurotoxic severity patterns.

Main Results:

• Significant differences were observed in severity grade distribution between NCI-CTCAE/TNSc and QLQ-CIPN20 scores, with some overlap.
• Identified three distinct clusters of CIPN severity: severely, intermediately, and mildly impaired.
• No significant differences in demographics, cancer types, or drug classes were found across clusters.

Conclusions:

• Confirmed heterogeneity in CIPN perception between patients and physicians.
• Identified three well-defined patient subgroups based on CIPN impairment using TNSc and QLQ-CIPN20 scores.
• A derived calculator tool for individual patient classification requires prospective validation for refined CIPN assessment.