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

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

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalSupportive Care in Cancer
DOIs
StateAccepted/In press - Aug 18 2016

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oxaliplatin
Paclitaxel
Drug Therapy
Foot
Therapeutics
Hand
Hypesthesia
Peripheral Nervous System Diseases
Pharmaceutical Preparations

Keywords

  • Chemotherapy-induced peripheral neuropathy
  • Oxaliplatin neuropathy
  • Paclitaxel neuropathy

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology

Cite this

Pachman, D. R., Qin, R., Seisler, D., Smith, E. M. L., Kaggal, S., Novotny, P., ... Loprinzi, C. L. (Accepted/In press). Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505). Supportive Care in Cancer, 1-10. https://doi.org/10.1007/s00520-016-3373-1

Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505). / Pachman, Deirdre R.; Qin, Rui; Seisler, Drew; Smith, Ellen M Lavoie; Kaggal, Suneetha; Novotny, Paul; Ruddy, Kathryn J; Lafky, Jacqueline M.; Ta, Lauren E.; Beutler, Andreas S; Wagner-Johnston, Nina D.; Staff, Nathan P; Grothey, Axel F; Dougherty, Patrick M.; Cavaletti, Guido; Loprinzi, Charles Lawrence.

In: Supportive Care in Cancer, 18.08.2016, p. 1-10.

Research output: Contribution to journalArticle

Pachman, DR, Qin, R, Seisler, D, Smith, EML, Kaggal, S, Novotny, P, Ruddy, KJ, Lafky, JM, Ta, LE, Beutler, AS, Wagner-Johnston, ND, Staff, NP, Grothey, AF, Dougherty, PM, Cavaletti, G & Loprinzi, CL 2016, 'Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505)', Supportive Care in Cancer, pp. 1-10. https://doi.org/10.1007/s00520-016-3373-1
Pachman, Deirdre R. ; Qin, Rui ; Seisler, Drew ; Smith, Ellen M Lavoie ; Kaggal, Suneetha ; Novotny, Paul ; Ruddy, Kathryn J ; Lafky, Jacqueline M. ; Ta, Lauren E. ; Beutler, Andreas S ; Wagner-Johnston, Nina D. ; Staff, Nathan P ; Grothey, Axel F ; Dougherty, Patrick M. ; Cavaletti, Guido ; Loprinzi, Charles Lawrence. / Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505). In: Supportive Care in Cancer. 2016 ; pp. 1-10.
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AU - Ruddy, Kathryn J

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AU - Beutler, Andreas S

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AU - Staff, Nathan P

AU - Grothey, Axel F

AU - Dougherty, Patrick M.

AU - Cavaletti, Guido

AU - Loprinzi, Charles Lawrence

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N2 - 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.

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