Journal Article

Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505)

Seisler, Drew, Qin, Rui, Wagner-Johnston, Nina D., Cavaletti, Guido, Beutler, Andreas S., Novotny, Paul, Lafky, Jacqueline M., Kaggal, Suneetha, Ruddy, Kathryn J., Grothey, Axel, Staff, Nathan P., Loprinzi, Charles L., Pachman, Deirdre R., Smith, Ellen M. Lavoie, Ta, Lauren E., Dougherty, Patrick M.

2016

Overview

Purpose Oxaliplatin and paclitaxel are commonly used chemotherapies associated with acute and chronic neuropathies. There is a need to better understand the similarities and differences of these clinical syndromes. Methods Neuropathy data were pooled from patients receiving adjuvant oxaliplatin and weekly paclitaxel or every 3 weeks of paclitaxel. Patients completed daily questionnaires after each chemotherapy dose and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire for patients with chemotherapy-induced peripheral neuropathy before each chemotherapy cycle and for 12 months post-treatment. Results Acute neuropathy symptoms from both drugs peaked around day 3. Acute symptoms experienced in cycle 1 predicted occurrence in subsequent cycles. Paclitaxel-induced acute symptoms were similar in intensity in each cycle and largely resolved between cycles. Oxaliplatin-induced acute symptoms were about half as severe in the first cycle as in later cycles and did not resolve completely between cycles. Both drugs caused a predominantly sensory chronic neuropathy (with numbness and tingling being more common than pain). Oxaliplatin-induced neuropathy worsened after the completion of treatment and began to improve 3 months post-treatment. In contrast, paclitaxel-induced neuropathy began improving immediately after chemotherapy cessation. During treatment, the incidence of paclitaxel sensory symptoms was similar in the hands and feet; with oxaliplatin, the hands were affected more than the feet. Both paclitaxel- and oxaliplatin-induced acute neurotoxicity appeared to predict the severity of chronic neuropathy, more prominently with oxaliplatin. Conclusions Knowledge of the similarities and differences between neuropathy syndromes may provide insight into their underlying pathophysiology and inform future research to identify preventative treatment approaches.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Adult / Aged / Antineoplastic Agents, Phytogenic - administration & dosage / Antineoplastic Agents, Phytogenic - therapeutic use / Cancer / Cancer research / Chemotherapy / Chronic pain / Clinical outcomes / Comparative analysis / Drugs / Female / Hands / Humans / Induced / Male / Mediation / Medical schools / Medical treatment / Medicine / Medicine & Public Health / Middle Aged / Nursing / Nursing Research / Oncology / Organoplatinum Compounds - administration & dosage / Organoplatinum Compounds - therapeutic use / Original Article / Oxaliplatin / Paclitaxel - administration & dosage / Paclitaxel - therapeutic use / Pain Medicine / Pathophysiology / Patients / Peripheral Nervous System Diseases - chemically induced / Peripheral Nervous System Diseases - drug therapy / Peripheral neuropathy / Preventive medicine / Quality of life / Questionnaires / Rehabilitation Medicine / Sensory stimulation / Side effects / Treatment methods