The Future of Chemotherapy: The Mechanisms and Benefits of Exercise in Taxane-Induced Peripheral Neuropathy

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side-effect resulting from numerous neurotoxic chemotherapies that damages the peripheral nerves, alters sensations in the hands and feet, causes burning and shooting pains, and impairs a patient’s quality of life (QoL). There are limited established interventions to help improve CIPN symptoms. There is only one pharmacological agent (Duloxetine) for treatment of CIPN; however, it only has mild benefit, signaling a critical need for alternative management options to manage patient symptoms. Multiple studies suggest therapeutic benefits of exercise in cancer care to improve physical and psychological functioning; however, the benefits regarding CIPN symptoms and physical function are less clear. This narrative review synthesizes research articles investigating the effect and mechanisms induced by different exercise programs for patients with taxane-induced peripheral neuropathy (TIPN) symptoms and function. The overall incidence, manifestations, characteristics, and mechanisms of CIPN are also discussed. While some studies in this narrative review demonstrated that exercise programs may have benefits on sensory and motor TIPN symptoms in some but not all patients, there are consistent benefits of improved QoL and physical function across most patients. This narrative review highlights the need for future research to confirm the effects of exercise for TIPN, with a focus on other important components, including the effect of exercise adherence, type, and supervision level.