1662 - Efficiency of controlled cryotherapy in prevention of chemotherapy induced peripheral neuropathy (CIPN)

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of many commonly used chemotherapeutic agents, especially taxane-based regimen (Paclitaxel, nab-Paclitaxel, Docetaxel). The CIPN reduces patients health-related quality of life for years and often results in dose delay, dose reduction or treatment discontinuation. The prophylactic use of controlled cryotherapy (Hilotherapy®) prevents chemotherapy-induced-peripheral neuropathy (CIPN).

Methods

162 breast cancer patients treated with taxane based therapeutic regimen used prophylactic Hilotherapy® to cool hands and feet during chemotherapy infusion between 10/2016 – 02/2019. Hilotherapy® is a new physical thermotherapy device, equiped with hand and foot cuffs to allow a constant cooling in a localized and targeted manner. Continous cooling of hands and feet was performed 30 minutes before to 60 minutes after completing drug infusion with a temperature of 10-12 °C. CIPN symptoms were evaluated after each treatment cycle using common terminology criteria for adverse events (CTCAE). The sustainability of the impact was assessed by long-term datas (Follow Up patient contact every 3 months).

Results

122 patients have finished their chemotherapy treatments with prophylactic hand-feet cooling using Hilotherapy®, 39 patients are still under therapy. 113 patients (92.6%) developed none or mild symptoms of CIPN (grade 0-1). 8 patients (6,6%) reported grade 2 toxicity, 1 patient grade 3 (0,8%). The symptoms of CIPN were reversible. Four weeks after the last chemotherapy treatment, 5 patients (4,5%) still reported grade 2 toxicity, none of them suffered from grade 3. Another 3 months later, 2 patients (2,2%) reported an intermittent toxicity of grade 2. Long-term Follow Up datas confirm the lasting results.

Conclusions

Prophylactic Hilotherapy® prevented limiting CIPN Symptoms (> grade 1) in 93% of patients. 7% of the patients developed reversible toxicities grade 2/3. 4 months after chemotherapy treatment, all patients were without any limiting symptoms (grade ≤ 1), except two patients (grade 2). No dose modifications or treatment interruptions had been necessary.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Hilotherm GmbH.

Disclosure

T. Schaper: Honoraria (self), Advisory / Consultancy: Paxman; Honoraria (self), Travel / Accommodation / Expenses: Hilotherm; Honoraria (self), Advisory / Consultancy: EAoS; Honoraria (self): Roche. M. Darsow: Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Genomic Health; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Amgen. All other authors have declared no conflicts of interest.