Poster Presentation 2025 National Cancer Survivorship Conference

Screening for chemotherapy-induced peripheral neurotoxicity (CIPN): Patient acceptability of implementation in routine clinical care (#152)

Alice Treloar 1 , Peter Grimison 2 , Victoria Choi 2 , Tiffany Li 1 , Jed Young 3 , Katelin Mayer 3 , David Mizrahi 4 , Lisa Horvath 2 , David Goldstein 3 5 , Susanna Park 1
  1. University of Sydney, Camperdown, NSW, Australia
  2. Chris O'Brien Lifehouse, Sydney, NSW, Australia
  3. Prince of Wales Hospital, Sydney, NSW, Australia
  4. Daffodil Centre, University of Sydney, Sydney, NSW, Australia
  5. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW

Background: Chemotherapy-induced nerve damage or peripheral neuropathy (CIPN) is a concerning and potentially long-lasting consequence of cancer therapy, but evidence of the best way to implement routine screening for CIPN is lacking. This study examined the implementation of routine CIPN screening to understand acceptability and barriers and promote early identification of CIPN in clinical care.

 

Methods: Patients scheduled for neurotoxic chemotherapy treatment were recruited prospectively across two sites. Three brief patient-reported outcome (PROM) screening tools (Patient Neurotoxicity Questionnaire, NCI-PRO-CTCAE and the Cancer Institute NSW EviQ online neurotoxicity instrument) were completed (termed CIPN-Screen), with the longer PROM (EORTC_CIPN20) completed by symptomatic patients. Patient acceptability was assessed via short questionnaire. CIPN-Screen was deployed through patient invitation to complete electronic or paper-based surveys during appointments (Centre 1) or via automated text messages linked to appointment schedules (Centre 2).

 

Results: 755 screens were undertaken in 159 participants, with a median of 1 (1) screens per patient at Centre 1 and 8 (6) screens per patient at Centre 2.  417 screens (56.0%) identified CIPN symptoms, with 134 (18.0%) of screens identifying moderate to severe symptoms per NCI-PRO-CTCAE scale. Most respondents reported that the CIPN-Screen was easy to complete (92.0%, n=671), easy to understand (91.6%, n=668), and helpful to describe symptoms (85.6%, n=624). Acceptability did not differ by centre, age, sex, or chemotherapy type; however, did differ according to CIPN symptom severity (P = 0.0002). CIPN-Screen detected the evolution of symptoms over time, with increased symptom burden from the first screen to the 7th (P <0.0001, n=49). All CIPN-Screen screening tools were positively moderately to strongly correlated to each other (ρ ≥ 0.66 to 0.88) but less strongly correlated to longer PROM EORTC_CIPN20 (ρ ≥0.44 to 0.76).

 

Conclusion: Routine CIPN screening is acceptable from a patient perspective and identifies worsening toxicity in patients treated with neurotoxic chemotherapy.