In a German single-center trial (POLAR) reported in JAMA Oncology, Michel et al found that hand cooling and hand compression were associated with a reduced risk of taxane-induced neuropathy in women with primary breast cancer.
Study Details
In the trial, 101 patients enrolled at the National Center for Tumor Diseases Heidelberg between November 2019 and January 2022 were randomly assigned to undergo cooling (n = 52) or compression (n = 49) of the dominant hand, with no treatment of the nondominant hand. Patients who had received weekly nab-paclitaxel–based or paclitaxel-based neoadjuvant or adjuvant chemotherapy were enrolled; patients who had received prior chemotherapy or had preexisting neuropathy/neuropathy-related comorbidities were excluded from analysis. Hand cooling was performed with a frozen glove, and hand compression was applied by two surgical gloves (one size smaller than the tight-fitting size) 30 minutes before, after, and during taxane administration. The primary endpoint was prevention of grade ≥ 2 chemotherapy-induced peripheral neuropathy (CIPN).
Key Findings
Both interventions significantly reduced the incidence of grade ≥ 2 CIPN. In the hand cooling group, 15 patients (29%) had grade ≥ 2 CIPN in the treated arm vs 26 patients (50%) in the control arm (P = .022; effect size = 21.15%, 95% confidence interval [CI] = 5.98%–35.55%). In the hand compression group, grade ≥ 2 CIPN occurred in 12 patients (24%) in the treatment arm vs 19 patients (38%) in the control arm (P = .008; effect size = 14.29%, 95% CI = 2.02%–27.24%).
Patients with grade ≥ 2 CIPN had reduced global health status during and 6 to 8 months after taxane therapy.
The investigators concluded: “In this randomized clinical trial, [hand] cooling and compression were highly effective and significantly reduced the risk of high-grade CIPN.”
Laura L. Michel, MD, PhD, of the National Center for Tumor Diseases, Heidelberg University Hospital, is the corresponding author of the JAMA Oncology article.
Disclosure: The study was supported by the National Center for Tumor Diseases, Heidelberg. For full disclosures of the study authors, visit jamanetwork.com.
