Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy, affecting motor, sensory, and autonomic function. Accurate assessment is important during treatment, when CIPN may necessitate dose reductions or discontinuation, and after treatment, as chronic CIPN can greatly impact quality of life and safety in cancer survivorship. Measurement tools can include subjective measures, including clinician-based grading scales or patient-reported outcome measures (PROMs), and objective measures. This review aimed to summarize current CIPN assessment tools, highlighting characteristics such as feasibility, minimum clinically important differences (MCIDs), validity and reliability to allow for comparison and selection of tools by clinicians and researchers. Methods: Following the Scale for the Assessment of Narrative Review Articles methodology guidelines, 2 investigators performed a comprehensive literature search using predefined search terms relating to CIPN measurement. Additional papers were identified through a search of prior systematic reviews and tracing back references from key articles. Data were extracted from source papers and any available appendices. Results: We identified 3 clinician-based grading scales, 20 PROMs, and 8 objective measurement tools. While the majority of tools have been validated for neuropathy, a minority of them have established MCIDs and validation in CIPN-specific populations. Conclusions: Tool selection should align with the specific needs of clinicians and researchers. Instruments that are valid, reliable, and assess multiple CIPN domains are recommended. Further research is needed to validate many of these tools in CIPN-specific populations and to determine their MCIDs.

Background: Adolescent and young adult (AYA) cancer survivors have unique needs, yet few tailored rehabilitation programs exist. CaRE-AYA is an 8-week multidimensional rehabilitation program for AYAs that targets impairments, activity limitations and participation restrictions and comprises an individualized exercise prescription and weekly group-based exercise and self-management education. Methods: We conducted a single-arm multi-method pragmatic feasibility study evaluating CaRE-AYA’s feasibility, acceptability, and safety (primary outcomes) and assessed disability, physical functioning, mental health, and social functioning at baseline (T0), immediately post-intervention (T1), and 3 months post-intervention (T2). Results: Twenty-five participants (median age: 32.8, 76% female) were enrolled. Participation (60%), retention (84% at T1, 72% at T2), and program adherence (76% for education classes, 74% for exercise classes) supported feasibility. Qualitative interviews (n = 9) supported strong perceptions of feasibility and acceptability. No serious adverse events (≥grade 3) attributed to CaRE-AYA occurred. Conclusions: The results suggest CaRE-AYA is feasible, acceptable, and safe. A randomized controlled trial is needed to determine the effectiveness.

Background: Chemotherapy-induced peripheral neurotoxicity (CIPN) is a prevalent adverse effect of chemotherapy agents that is estimated to be present in 2/3 of patients who receive neurotoxic chemotherapy. In 30–40% of these patients, CIPN signs and symptoms can persist for months or years post-treatment. Recent studies have supported exercise as a feasible and possibly effective intervention for CIPN; however, more rigorous studies are needed to confirm feasibility, estimate efficacy, and clarify risk. In response, we developed an innovative virtual exercise-based rehabilitation program (EX-CIPN) for cancer survivors with persistent CIPN. Methods: This study is a phase I study conducted at the Princess Margaret Cancer Centre in cancer survivors with persistent CIPN, with a focus on feasibility, acceptability, and safety. A total of 40 patients aged 18 or older, with persistent CIPN at least 6 months after chemotherapy completion will be recruited and receive the EX-CIPN program. The EX-CIPN program is a 10-week virtual home-based intervention that includes an individualized exercise program supported with a mobile application (Physitrack), wearable technology (FitBit), and weekly virtual check-ins with an oncology exercise specialist. The primary outcome of feasibility will be assessed by examining accrual, retention, and adherence rates. Acceptability will be assessed through qualitative interviews. Safety events will be monitored and reported based on CTCAE v5. Secondary outcomes will be collected using questionnaires and physiological assessments at baseline (T1), after the intervention (T2), and 3-months after intervention (T3). Conclusion: This phase I study will determine intervention feasibility, acceptability, and safety and will inform the planning for a future Phase II RCT with the EX-CIPN intervention.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) affects two-thirds of patients who receive neurotoxic chemotherapy. In almost half of these patients, CIPN is persistent, with limited treatment options. Exercise-based rehabilitation shows promising results in improving CIPN-related outcomes, but high-quality research is needed with CIPN symptoms and disability as primary endpoints. Methods: We conducted a phase I single-arm, multi-method pilot study of a 10-week remotely delivered exercise-based rehabilitation program (EX-CIPN) for adult (≥18-years) cancer survivors experiencing CIPN symptoms ≥6 months post-chemotherapy. Primary outcomes were feasibility (accrual, retention, and adherence), acceptability (interviews and surveys), and safety (CTCAE v5). Secondary outcomes included pain, CIPN symptoms, CIPN-related disability, and physiologic assessments. Assessments were conducted at baseline (T1), post-program (T2), and 3 months post-program (T3). Post-program feedback surveys were completed at T2 and semi-structured qualitative video interviews were completed between T2 and T3. Results: In total, 36 participants (median age: 59, 83% female) consented to participate in the study. T1 retention rate (90%), adherence rates (77–96%), and no reported serious adverse events (Grade 3 CTCAE v5) supported study feasibility and safety. Interviews and surveys supported intervention acceptability. Retention rates at T2 (68%) and T3 (63%) did not reach feasibility targets. CIPN symptoms and CIPN-related disability showed significant improvement at T3 (p < 0.001). Conclusions: Results suggest that EX-CIPN has encouraging feasibility outcomes and is acceptable and safe. Preliminary clinical outcome results are promising. Based on these study results, we can proceed to test this intervention, with a few modifications, in a prospective randomised trial with a CIPN-related primary outcome.