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. 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.