Kuriyama, A., & Endo, K. (2018). Goshajinkigan for prevention of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. Supportive Care in Cancer, 26, 1051–1059.

STUDY PURPOSE: Examine whether goshajinkagin prevents CIPN in patients receiving neurotoxic chemotherapy.

TYPE OF STUDY: Meta analysis and systematic review

DATABASES USED: PubMed, EMBASE, Ichushi, Cochrane Central Register of Controlled Trials

YEARS INCLUDED: (Overall for all databases) inception through August, 2017

INCLUSION CRITERIA: Randomized controlled trials that assessed efficacy and safety of goshajinkagin in preventing CIPN; patients had to be undergoing neurotoxic chemotherapy (taxanes, vinca alkaloids, platinum agents); adult patients older than age 18 years ; prophylactic doses of goshajinkagin (7.5 g per day)

EXCLUSION CRITERIA: Patients that had already developed CIPN; dosing of goshajinkagin that was given as treatment for CIPN rather than prophylaxis

TOTAL REFERENCES RETRIEVED: 234 articles retrieved; five articles evaluable after inclusion/exclusion applied

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Five trials with 397 total patients; 3 colon cancer, 2 breast cancer

FINAL NUMBER STUDIES INCLUDED: 5 

TOTAL PATIENTS INCLUDED IN REVIEW: 397

SAMPLE RANGE ACROSS STUDIES: Included patients with breast cancer or colon cancer, receiving FOLFOX 4 or FOLFOX 6, and weekly paclitaxel- or docetaxel-based chemotherapy. Studies ranged from 18-186 patients; studies ranged from 12-26 weeks in duration. Two trials with placebo comparator; two trials with no interventions for control; one trial administered mecobalamin for comparison; one trial terminated early due to incidence of increased CIPN. Two different definitions of CIPN used, those from NCI-CTCAE in four studies (measuring severity) and that from the Neurotoxicity Criteria of Debiopharm (DEB-NTC) in one study (measuring duration)

KEY SAMPLE CHARACTERISTICS: 35-88 years old; breast cancer and colon cancer

PHASE OF CARE: Active anti-tumor treatment

Overall, the use of goshajinkagin was not related to a decreased incidence of CIPN; though in the one study there was reduced incidence of grade 1 and grade 3 CIPN, but no difference in grade 2 CIPN. One study with increased incidence of CIPN (stopped early).

No evidence to support the use of goshajinkagin for prevention of CIPN.

• Limited number of studies included
• High heterogeneity
• Different criteria for grading of CIPN

Further research on use of the medication may be warranted. Education of patients about the inconsistent results.