Oxaliplatin rechallenge in metastatic colorectal cancer patients with clinically significant oxaliplatin‐induced peripheral neurotoxicity. Issue 1 (30th December 2020)

• Record Type: Journal Article
• Authors: Argyriou, Andreas A.; Kalofonou, Foteini; Litsardopoulos, Pantelis; Anastopoulou, Garifallia G.; Kalofonos, Haralabos P.
• Is Part Of: Journal of the peripheral nervous system. Volume 26:Issue 1(2021)
• Page Start: 43
• Page End: 48
• Publication Date: 2020-12-30
• Subjects: oxaliplatin‐induced peripheral neurotoxicity -- risk factors -- rechallenge -- worsening severity; Nervous system -- Periodicals; Nerves, Peripheral -- Diseases -- Periodicals; Peripheral Nervous System Diseases -- Periodicals; Peripheral Nervous System -- Periodicals; 612.81
• DOI: 10.1111/jns.12426
• Languages: English
• ISSNs: 1085-9489

Abstract

Abstract: We investigated whether rechallenge with oxaliplatin (OXA) can worsen the pre‐existing oxaliplatin‐induced peripheral neurotoxicity (OXAIPN) in metastatic colorectal cancer (mCRC) patients. Patients previously treated with OXA, having clinically significant grade 1 or 2 OXAIPN were assessed, after receiving rechallenge with OXA, using the clinical version of the Total Neuropathy Score (TNSc). Peripheral neuropathy was assessed at the end of first OXA exposure and at completion of OXA rechallenge. The first line OXA‐based chemotherapy was completed at least 9 months earlier (OXA‐free interval). We studied 25 mCRC patients, 14 males and 11 females, with a median age of 63 (35‐77) years. After their first exposure to OXA‐based chemotherapy, 9 (36%) patients developed grade 1 OXAIPN and 16 patients grade 2 (64%) neurotoxicity. OXA reintroduction with a median of 10 (8‐14) cycles led to grade 1 OXAIPN in two patients (8%), grade 2 in 19 patients (76%), and grade 3 neuropathy in 4 (16%) patients Worsening of pre‐existing OXAIPN was documented in seven (28%) patients and was significantly associated with higher OXA delivered cumulative dose ( P < .001). Median TNSc scores following treatment (10; range 4‐18) were significantly increased ( P < .001), when compared to the scores recorded at the end of first line treatment (8; range 2‐12). Rechallenging OXA appears to relatively worsen the severity of existing OXAIPN. However, the majority of rechallenged patients developed a clinically significant (grade 2) OXAIPN, rather than treatment‐emergent grade 3. As such, OXA rechallenge might be a feasible option in patients previously having OXAIPN.