Management of Chemotherapy-Induced Peripheral Neuropathy (CIPN) in Oncologic Patients-A New Promise? Preliminary...

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, often debilitating side effect of several chemotherapeutic agents, particularly taxanes and platinum compounds. Current management strategies remain limited, with few agents demonstrating consistent efficacy. Our aim was to evaluate the efficacy and safety of a novel topical cream containing 1% amitriptyline and 0.5% ketamine in alleviating CIPN symptoms in oncology patients.

A prospective observational study was conducted at Barzilai Medical Center following the approval of the local ethics committee. Thirty-seven patients (30 females, 7 males; age 40-75) with CIPN following taxane or platinum-based chemotherapy were treated with a topical cream applied three times daily for 28 weeks. Pain intensity was assessed using the Visual Analog Scale (VAS). Inclusion and exclusion criteria were strictly applied to ensure a homogenous cohort.

Initial mean VAS was 7 (range 6-10), which decreased to a final mean VAS of 3 (range 1-7). Two patients withdrew from the study, and 27 out of 35 evaluable patients (77.14%) reported significant symptoms relief. A statistically significant reduction in pain scores (p = 0.00005) was seen in our study. Only mild, transient erythema was reported as a side effect.

This is the first clinical evaluation of a topical combination with new concentrations of amitriptyline and ketamine for CIPN. The results suggest this formulation offers a safe and effective option for symptomatic relief. Larger randomized controlled trials and exploration of transdermal delivery systems are warranted to validate these findings and optimize treatment outcomes.