Cannabinoids

Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain

Henry L. Blanton, Jennifer Brelsfoard, Nathan DeTurk, Kevin Pruitt, Madhusudhanan Narasimhan, Daniel Morgan, Josée Guindon

Research output: Contribution to journalReview article

Abstract

Increases in cancer diagnosis have tremendous negative impacts on patients and their families, and major societal and economic costs. The beneficial effect of chemotherapeutic agents on tumor suppression comes with major unwanted side effects such as weight and hair loss, nausea and vomiting, and neuropathic pain. Chemotherapy-induced peripheral neuropathy (CIPN), which can include both painful and non-painful symptoms, can persist 6 months or longer after the patient’s last chemotherapeutic treatment. These peripheral sensory and motor deficits are poorly treated by our current analgesics with limited effectiveness. Therefore, the development of novel treatment strategies is an important preclinical research focus and an urgent need for patients. Approaches to prevent CIPN have yielded disappointing results since these compounds may interfere with the anti-tumor properties of chemotherapeutic agents. Nevertheless, the first (serotonin noradrenaline reuptake inhibitors [SNRIs], anticonvulsants, tricyclic antidepressants) and second (5% lidocaine patches, 8% capsaicin patches and weak opioids such as tramadol) lines of treatment for CIPN have shown some efficacy. The clinical challenge of CIPN management in cancer patients and the need to target novel therapies with long-term efficacy in alleviating CIPN are an ongoing focus of research. The endogenous cannabinoid system has shown great promise and efficacy in alleviating CIPN in preclinical and clinical studies. In this review, we will discuss the mechanisms through which the platinum, taxane, and vinca alkaloid classes of chemotherapeutics may produce CIPN and the potential therapeutic effect of drugs targeting the endocannabinoid system in preclinical and clinical studies, in addition to cannabinoid compounds diffuse mechanisms of action in alleviation of CIPN.

Original languageEnglish (US)
Pages (from-to)969-995
Number of pages27
JournalDrugs
Volume79
Issue number9
DOIs
StatePublished - Jun 1 2019

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Cannabinoids
Neuralgia
Peripheral Nervous System Diseases
Drug Therapy
Neoplasms
Vinca Alkaloids
Tramadol
Endocannabinoids
Tricyclic Antidepressive Agents
Capsaicin
Alopecia
Therapeutic Uses
Therapeutics
Drug Delivery Systems
Lidocaine
Platinum
Research
Anticonvulsants
Nausea
Opioid Analgesics

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Blanton, H. L., Brelsfoard, J., DeTurk, N., Pruitt, K., Narasimhan, M., Morgan, D., & Guindon, J. (2019). Cannabinoids: Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain. Drugs, 79(9), 969-995. https://doi.org/10.1007/s40265-019-01132-x
Blanton, Henry L. ; Brelsfoard, Jennifer ; DeTurk, Nathan ; Pruitt, Kevin ; Narasimhan, Madhusudhanan ; Morgan, Daniel ; Guindon, Josée. / Cannabinoids : Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain. In: Drugs. 2019 ; Vol. 79, No. 9. pp. 969-995.
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abstract = "Increases in cancer diagnosis have tremendous negative impacts on patients and their families, and major societal and economic costs. The beneficial effect of chemotherapeutic agents on tumor suppression comes with major unwanted side effects such as weight and hair loss, nausea and vomiting, and neuropathic pain. Chemotherapy-induced peripheral neuropathy (CIPN), which can include both painful and non-painful symptoms, can persist 6 months or longer after the patient’s last chemotherapeutic treatment. These peripheral sensory and motor deficits are poorly treated by our current analgesics with limited effectiveness. Therefore, the development of novel treatment strategies is an important preclinical research focus and an urgent need for patients. Approaches to prevent CIPN have yielded disappointing results since these compounds may interfere with the anti-tumor properties of chemotherapeutic agents. Nevertheless, the first (serotonin noradrenaline reuptake inhibitors [SNRIs], anticonvulsants, tricyclic antidepressants) and second (5{\%} lidocaine patches, 8{\%} capsaicin patches and weak opioids such as tramadol) lines of treatment for CIPN have shown some efficacy. The clinical challenge of CIPN management in cancer patients and the need to target novel therapies with long-term efficacy in alleviating CIPN are an ongoing focus of research. The endogenous cannabinoid system has shown great promise and efficacy in alleviating CIPN in preclinical and clinical studies. In this review, we will discuss the mechanisms through which the platinum, taxane, and vinca alkaloid classes of chemotherapeutics may produce CIPN and the potential therapeutic effect of drugs targeting the endocannabinoid system in preclinical and clinical studies, in addition to cannabinoid compounds diffuse mechanisms of action in alleviation of CIPN.",
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Blanton, HL, Brelsfoard, J, DeTurk, N, Pruitt, K, Narasimhan, M, Morgan, D & Guindon, J 2019, 'Cannabinoids: Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain', Drugs, vol. 79, no. 9, pp. 969-995. https://doi.org/10.1007/s40265-019-01132-x

Cannabinoids : Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain. / Blanton, Henry L.; Brelsfoard, Jennifer; DeTurk, Nathan; Pruitt, Kevin; Narasimhan, Madhusudhanan; Morgan, Daniel; Guindon, Josée.

In: Drugs, Vol. 79, No. 9, 01.06.2019, p. 969-995.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Cannabinoids

T2 - Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain

AU - Blanton, Henry L.

AU - Brelsfoard, Jennifer

AU - DeTurk, Nathan

AU - Pruitt, Kevin

AU - Narasimhan, Madhusudhanan

AU - Morgan, Daniel

AU - Guindon, Josée

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Increases in cancer diagnosis have tremendous negative impacts on patients and their families, and major societal and economic costs. The beneficial effect of chemotherapeutic agents on tumor suppression comes with major unwanted side effects such as weight and hair loss, nausea and vomiting, and neuropathic pain. Chemotherapy-induced peripheral neuropathy (CIPN), which can include both painful and non-painful symptoms, can persist 6 months or longer after the patient’s last chemotherapeutic treatment. These peripheral sensory and motor deficits are poorly treated by our current analgesics with limited effectiveness. Therefore, the development of novel treatment strategies is an important preclinical research focus and an urgent need for patients. Approaches to prevent CIPN have yielded disappointing results since these compounds may interfere with the anti-tumor properties of chemotherapeutic agents. Nevertheless, the first (serotonin noradrenaline reuptake inhibitors [SNRIs], anticonvulsants, tricyclic antidepressants) and second (5% lidocaine patches, 8% capsaicin patches and weak opioids such as tramadol) lines of treatment for CIPN have shown some efficacy. The clinical challenge of CIPN management in cancer patients and the need to target novel therapies with long-term efficacy in alleviating CIPN are an ongoing focus of research. The endogenous cannabinoid system has shown great promise and efficacy in alleviating CIPN in preclinical and clinical studies. In this review, we will discuss the mechanisms through which the platinum, taxane, and vinca alkaloid classes of chemotherapeutics may produce CIPN and the potential therapeutic effect of drugs targeting the endocannabinoid system in preclinical and clinical studies, in addition to cannabinoid compounds diffuse mechanisms of action in alleviation of CIPN.

AB - Increases in cancer diagnosis have tremendous negative impacts on patients and their families, and major societal and economic costs. The beneficial effect of chemotherapeutic agents on tumor suppression comes with major unwanted side effects such as weight and hair loss, nausea and vomiting, and neuropathic pain. Chemotherapy-induced peripheral neuropathy (CIPN), which can include both painful and non-painful symptoms, can persist 6 months or longer after the patient’s last chemotherapeutic treatment. These peripheral sensory and motor deficits are poorly treated by our current analgesics with limited effectiveness. Therefore, the development of novel treatment strategies is an important preclinical research focus and an urgent need for patients. Approaches to prevent CIPN have yielded disappointing results since these compounds may interfere with the anti-tumor properties of chemotherapeutic agents. Nevertheless, the first (serotonin noradrenaline reuptake inhibitors [SNRIs], anticonvulsants, tricyclic antidepressants) and second (5% lidocaine patches, 8% capsaicin patches and weak opioids such as tramadol) lines of treatment for CIPN have shown some efficacy. The clinical challenge of CIPN management in cancer patients and the need to target novel therapies with long-term efficacy in alleviating CIPN are an ongoing focus of research. The endogenous cannabinoid system has shown great promise and efficacy in alleviating CIPN in preclinical and clinical studies. In this review, we will discuss the mechanisms through which the platinum, taxane, and vinca alkaloid classes of chemotherapeutics may produce CIPN and the potential therapeutic effect of drugs targeting the endocannabinoid system in preclinical and clinical studies, in addition to cannabinoid compounds diffuse mechanisms of action in alleviation of CIPN.

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