A prevention programme for chemotherapy nerve damage: SARM1 inhibitors, cooling and compression
Nerve damage from taxanes and platinum is common, often permanent and has no approved preventive. Test the most promising candidates head to head in one programme.
Chemotherapy-induced peripheral neuropathy affects a large share of patients treated with taxanes, platinum or bortezomib and drives dose reduction. SARM1, an executioner of axon degeneration, is validated genetically in mouse models and inhibitors are in early clinical development for other neuropathies; HDAC6 inhibitors and cryotherapy or compression of hands and feet have supportive data. The proposal is a multi-arm platform trial in adjuvant breast and colorectal cancer comparing candidate preventives against placebo with a patient-reported neuropathy endpoint (EORTC CIPN20) and quantitative sensory testing.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
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