Abstract Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating side effect, adversely impacting quality of life (QoL) and treatment outcomes in breast cancer patients. Preventive strategies for CIPN remain limited. Acupuncture has shown promise in mitigating CIPN symptoms, but its role in prevention requires further investigation. This study evaluates acupuncture’s effectiveness in preventing CIPN in early-stage breast cancer patients through a pooled analysis of three coordinated international trials. Methods: Patients with stage I-III breast cancer, with no prior neuropathic symptoms, scheduled for taxane-based chemotherapy were randomized 1:1 to acupuncture or relaxation exercises with nature videos as the control in three parallel trials in the USA, China, and South Korea. Participants in the acupuncture group received 14 standardized sessions over 12 weeks, starting before the second chemotherapy cycle. Participants in the control group received nature video relaxation during chemotherapy infusions. Follow-up extended for an additional 12 weeks. The primary endpoint was the change in CIPN severity using EORTC CIPN-20 sensory subscale at 12 weeks. Secondary endpoints included CIPN incidence, pain intensity, and QoL at week 12 and week 24. Data were pooled and analyzed using longitudinal linear mixed-effects model, stratified by site and chemotherapy schedule (weekly vs. non-weekly). All analysis were intention to treat. Results: Of 129 patients who consented, 128 were randomized (USA: 88, China: 20, South Korea: 20) and 127 were analyzed (63 acupuncture, 64 control). Median age was 46 years (range: 30-80) in the acupuncture arm and 49 years (range: 26-77) in the control arm, with 58.2% White and 38.6% Asian. At baseline, patients reported similar CIPN-20 sensory scores between study arms 0.44 points (SE 0.77) vs. 1.29 (0.77), p=0.33. At week 12, patients in both arms reported a statistically significant increase of mean sensory change score 7.23 (1.75), 95%CI: 3.76-10.70, p0.0001; and 8.16 (1.67), 95%CI: 4.86-11.47, p0.0001, respectively. There are no statistically significant differences between the acupuncture arm vs. the control arm at week 12 and week 24 (Table). No acupuncture-related serious adverse events were observed. Conclusions: Acupuncture was safe and well-tolerated but did not significantly reduce the risk and severity of CIPN when compared to the nature video control in this pooled cohort. Secondary analyses are in progress and will be reported separately. Funding Source: The Ministry of Health 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-01-12.
Lu et al. (Tue,) studied this question.