ArticleFrontiers in pharmacology2026
Longitudinal patient-reported outcomes and predictors of improvement in chemotherapy-induced peripheral neuropathy a secondary analysis of a randomized trial.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) compromises function and quality of life (QoL) and may precipitate chemotherapy modification. We evaluated longitudinal Patient-reported outcome measures (PROMs) during duloxetine-based CIPN management and explored clinical predictors of response. Methods: This secondary longitudinal analysis was conducted within a randomized clinical cohort receiving duloxetine-based therapy for chemotherapy-induced peripheral neuropathy (CIPN). Of the patients included in the parent trial, 72 with analyzable patient-reported outcome data were included in the present analysis. PROMs were collected at baseline, week 4, and week 8 using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20-item module (EORTC QLQ- CIPN20), Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx), Brief Pain Inventory (BPI), and Hamilton Anxiety Rating Scale HAM-A, and were analyzed using generalized estimating equations with multivariable adjustment. Instruments included EORTC QLQ-CIPN20 (0-100; higher = worse), FACT/GOG-Ntx (higher = better), Brief Pain Inventory (BPI) severity and interference (0-10; higher = worse), and. Hamilton Anxiety Rating Scale (HAM-A; higher = worse). Results: In this PROM analysis, significant improvement was observed across CIPN symptoms, pain, anxiety, and QoL outcomes over 8 weeks. QLQ-CIPN20 total decreased at week 4 (MD -12.64) and week 8 (MD -23.81) versus baseline (both p < 0.001), with sensory (-13.71; -26.45), motor (-10.97; -22.06), and autonomic (-9.00; -18.44) domain reductions (all p < 0.001). FACT/GOG-Ntx increased in week 4 (MD +6.42) and week 8 (MD +7.46) (p < 0.001), with no significant week 4-to-week eight increment. HAM-A decreased (-3.42; -6.77), while BPI severity (-1.55; -2.78) and interference (-1.26; -2.60) improved (all p < 0.001). Higher baseline pain predicted worse CIPN, lower QoL, and higher anxiety; metastatic disease and chemotherapy dose reduction were associated with poorer outcomes; missingness showed no strong baseline predictors. Conclusion: Duloxetine-based management was associated with rapid, sustained improvement in CIPN symptoms, pain, anxiety, and QoL over 8 weeks, supporting risk-stratified supportive care pathways.
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