Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Effect of duloxetine on quality of life of cancer patients with chemotherapy-induced peripheral neuropathy: a crossover randomised controlled trial (125107)

Jennifer Vu 1 , Eva Battaglini 2 , Tiffany Li 1 , David Wyld 3 4 , Robert Henderson 5 , Gavin Marx 6 7 , Arun Krishnan 2 , David Goldstein 2 8 , Susanna Park 1
  1. Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  2. The University of New South Wales, Sydney, NSW, Australia
  3. Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
  4. Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
  5. Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
  6. Sydney Adventist Hospital, Sydney, NSW, Australia
  7. School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
  8. Prince of Wales Hospital, Sydney, NSW, Australia

Objectives/purpose

Chemotherapy-induced peripheral neuropathy (CIPN) can result in early chemotherapy cessation and chronic, disabling neuropathic symptoms. Duloxetine has previously demonstrated efficacy for symptom relief, however evidence is limited to painful CIPN, which is a phenotype experienced by less than half of all CIPN patients. This trial assessed whether duloxetine improves quality of life in the wider population of cancer patients with CIPN.

 

Sample and setting

20 patients with CIPN, prospectively recruited at two teaching hospitals in Australia; Prince of Wales Hospital, Sydney, and Royal Brisbane & Women's Hospital, Brisbane.

 

Procedures

A randomized, placebo-controlled crossover trial was conducted, with patients randomized to receive either 8 weeks of duloxetine followed by 8 weeks of placebo, or the reverse. Eligibility criteria included daily CIPN symptoms for at least 3 months following chemotherapy. The primary outcome measure was change in patient-reported neuropathic symptom burden via the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT-GOG-NTx) questionnaire.

 

Results

20 patients completed the trial, of which 35% reported painful CIPN. While both duloxetine and placebo demonstrated reduced FACT-GOG-NTx score after 8 weeks, only the mean score change in the placebo group exceeded the threshold of 2.8 for clinical importance (duloxetine mean score change; -1.41; 95% CI -3.65 to 0.838 vs. placebo -3.27; 95% CI -5.11 to -1.43; p=0.189).

 

Conclusions and clinical implications

In this small cohort, duloxetine did not demonstrate efficacy in improving overall symptom burden related to chemotherapy-induced peripheral neuropathy. There is still a need for effective treatments for this subgroup of cancer patients.