Abstract PS1-05-13: Cryotherapy combined with compression gloves and socks therapy reduce nab-paclitaxel-induced peripheral neuropathy in breast cancer patients undergoing neoadjuvant chemotherapy: a multicenter randomized controlled trial

Abstract Background: chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and dose-limiting toxicity of nab-paclitaxel in the treatment of breast cancer. Effective strategies to mitigate CIPN remain limited. Cryotherapy and compression therapy have shown promise in reducing CIPN, but prospective randomized data are scarce. We investigated whether the combined use of cryotherapy and compression gloves/socks could alleviate nab-paclitaxel-induced neuropathy in patients receiving neoadjuvant chemotherapy. Methods: this multicenter, prospective, randomized controlled trial enrolled patients with stage ≥T2, hormone receptor-positive node-positive or triple-negative breast cancer (TNBC). All patients received dose-dense anthracycline-based chemotherapy (90-100 mg/m2) for 4 cycles followed by nab-paclitaxel (260 mg/m2) every 2 weeks for 4 cycles. Patients were randomized (1:1) to either standard care (control) or cryotherapy with compression gloves and socks worn during nab-paclitaxel infusion (intervention). Peripheral neuropathy was assessed by NCI-CTCAE grading, the Patient Neurotoxicity Questionnaire (PNQ), and the EORTC QLQ-CIPN20. The primary endpoint was the incidence of grade ≥3 neuropathy. Secondary endpoints included the incidence of grade ≥2 neuropathy, quality of life and pathological complete response (pCR) rate.(NCT05341141) Results: a total of 102 patients were enrolled. Three participants withdrew, and 99 were included in the final analysis-50 in the intervention group and 49 in the control group. The incidence of grade ≥3 neuropathy was significantly lower in the intervention group compared with the control group (4.1% vs. 18.8%, P =0.023). Similarly, grade ≥2 neuropathy occurred less frequently in the intervention group, indicating a consistent reduction in neurotoxicity (36.7% vs. 63.8%, P =0.008). Patients in the intervention group also reported significantly lower scores on CIPN20 assessments (P =0.008). According to PNQ, the incidence of grade D or E showed no statistically significant difference between groups (P = 0.475). Among all patients receiving biweekly nab-paclitaxel, the total pCR rate was 25.8%. In the TNBC subgroup, the total pCR rate reached 50.0%. The rate of treatment discontinuation or dose reduction due to adverse events was 20.4% in the control group versus 10.0% in the intervention group. No serious adverse events related to cryocompression were observed. Conclusions: cryotherapy combined with compression therapy significantly reduced the incidence and severity of nab-paclitaxel-induced CIPN in the neoadjuvant setting, while improving patient quality of life and treatment tolerability. Biweekly nab-paclitaxel yielded an acceptable pCR rate, especially in patients with triple-negative breast cancer. These findings support cryocompression as a safe, non-pharmacologic strategy to mitigate CIPN in breast cancer patients. Keywords: breast cancer, nab-paclitaxel, cryotherapy, compression therapy, peripheral neuropathy, neoadjuvant chemotherapy Citation Format: L. Wang, Y. He, J. Li, X. Yu, H. Sun, J. Zhang, B. Hua, Z. Fan. Cryotherapy combined with compression gloves and socks therapy reduce nab-paclitaxel-induced peripheral neuropathy in breast cancer patients undergoing neoadjuvant chemotherapy: a multicenter randomized controlled trial [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-05-13.