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Oxaliplatin-induced Neuropathy in GI Cancers
Do symptoms resolve between cycles?
Acute oxaliplatin-induced neuropathy symptoms do not always resolve between treatment cycles, according to a study of 346 patients receiving adjuvant fluorouracil, leucovorin, and oxaliplatin (FOLFOX). Researchers found:
• 89% of patients had at least 1 symptom of acute neuropathy after the first FOLFOX cycle, including:
◊ Throat discomfort (63%)
◊ Muscle cramps (42%)
• Acute symptoms peaked at day 3 and improved, but did not always resolve between treatments.
• Symptoms were about twice as severe in cycles 2 through 12, compared to cycle 1.
• Of chronic neurotoxicity symptoms, tingling was most severe, followed by numbness and pain.
• During chemotherapy, symptoms in hands were initially more prominent than in feet; by 18 months foot symptoms were more severe than hand symptoms.
• Patients with more severe acute neuropathy during the first cycle of therapy experienced more chronic sensory neurotoxicity.
Citation: Pachman DR, Qin R, Seisler DK, et al. Clinical course of oxaliplatin-induced neuropathy: results from the randomized phase III trial N08CB (Alliance). [Published online ahead of print August 17, 2015]. J Clin Oncol. doi: 10.1200/JCO.2014.58.8533.