Systematic review and meta-analysis of studies of preventing hand-foot syndrome in patients with cancer

Hand-foot syndrome (HFS) is a common dose-limiting toxic effect of several chemotherapy agents. A systematic review and meta-analysis of phase 2 or 3 randomized controlled trials evaluated and compared the efficacy of pharmacologic interventions for the prevention of chemotherapy-induced HFS in patients with cancer. The primary endpoint was incidence of grade 2 or higher HFS. A total of 17 trials, comprising 2192 patients, were analyzed for the primary endpoint. Topical diclofenac, silymarin, 400-mg pyridoxine, and celecoxib significantly reduced the incidence of grade 2 or higher HFS compared with placebo; diclofenac and celecoxib were also effective in reducing overall HFS incidence. The authors conclude that these findings indicate that diclofenac is the agent with the best supportive evidence for prevention of HFS in patients with cancer.