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Duloxetine CIPN — SCE Medical Oncology MCQ

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ModerateSupportive & Palliative OncologyDuloxetine CIPNSCE Medical Oncology

A 60-year-old man with cancer develops chemotherapy-induced peripheral neuropathy (CIPN) grade 2 on oxaliplatin. What is the strongest evidence-based treatment once CIPN is established?

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Correct answer: D — Duloxetine is the only agent with positive phase III RCT evidence for established CIPN (CALGB 170601: modest but significant pain reduction) — gabapentin, pregabalin and other agents have not shown consistent benefit in randomised trials

CALGB 170601: duloxetine 60mg daily showed modest but significant improvement in CIPN pain vs placebo. No other pharmacological agent has positive phase III evidence. Prevention (dose modification, stop-and-go strategies) is more effective than treatment. Exercise and physical therapy may help functional outcomes.

Reference: ASCO CIPN Guidelines 2020; CALGB 170601 Smith et al JAMA 2013; ESMO Supportive Care