# Choose cold or compression for neuropathy by what patients can keep on

Source: https://onco.cc/ideas/idea-mach-cold-or-compression-by-adherence/  
OnCo record `idea-mach-cold-or-compression-by-adherence` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Frozen gloves, tight gloves and cooling machines all aim to protect the nerves during taxane chemotherapy, but many patients take the cold ones off. Matching the method to what each person tolerates may matter as much as which method is best on paper.

## Summary

In CONTRoL, adherence was 35.0 per cent with cryotherapy against 72.7 per cent with compression, and compression succeeded more often. In CROPSI, cryocompression was no better than cryotherapy. Self-controlled studies of frozen gloves and of compression gloves each showed large reductions, while a meta-analysis of frozen-glove trials was inconclusive. SWOG's ICE COMPRESS phase 3 trial is comparing approaches in 777 patients. The proposal is to record adherence and cold tolerance as primary measures alongside neuropathy in such trials and to offer patients a choice by tolerance in the meantime.

## Fields

- Kind: Idea
- Last checked: 2026-11-04
- Tags: machines-wave3; proposal
- Hypothesis: Neuropathy prevention depends on minutes of effective cooling or compression actually delivered, so an adherence-guided choice outperforms a single assigned method.
- Rationale: The trials that measured adherence found it very different between methods, and their outcomes tracked it.
- Proposed test: Secondary analysis of ICE COMPRESS by delivered dose of cooling or compression, then a pragmatic trial of patient-chosen against assigned method.
- Maturity: being-tested-at-scale
- Actor: clinic

## Sources

- Accordino et al., CONTRoL phase 2B: cryotherapy against compression against placebo (Breast Cancer Res Treat 2024): https://doi.org/10.1007/s10549-023-07172-y
- Brunner et al., CROPSI: cryotherapy against cryocompression in 200 patients (The Breast 2024): https://doi.org/10.1016/j.breast.2024.103763
- Wu et al., frozen gloves for neuropathy prevention: meta-analysis of 7 trials (Front Oncol 2024): https://doi.org/10.3389/fonc.2024.1366782
- ClinicalTrials.gov NCT05642611: https://clinicaltrials.gov/study/NCT05642611

## Connected records

- ideas: [A prevention programme for chemotherapy nerve damage: SARM1 inhibitors, cooling and compression](https://onco.cc/ideas/idea-moon-neuropathy-prevention-programme/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Frozen gloves, socks and compression for taxane nail and nerve damage](https://onco.cc/technologies/frozen-gloves-compression-taxane/), [Limb cryocompression devices for chemotherapy nerve damage (Paxman Neuropathy System, Hilotherm ChemoCare)](https://onco.cc/technologies/limb-cryocompression-devices/)
- drugs: [Docetaxel](https://onco.cc/drugs/docetaxel/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/)
- trials: [CONTRoL (cryotherapy against compression for neuropathy)](https://onco.cc/trials/control-cipn-trial/), [ICE COMPRESS (SWOG, cooling or compression of limbs to prevent neuropathy)](https://onco.cc/trials/ice-compress-swog/)
- bottlenecks: [Survivorship and late effects are neglected](https://onco.cc/bottlenecks/b-survivorship/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- roadmaps: [Comfort devices at the chemotherapy chair: scalp cooling, cold caps, limb cryocompression and infusion chairs](https://onco.cc/roadmaps/chemo-chair-comfort-devices-roadmap/)

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