Thalidomide neuropathy in patients treated for metastatic prostate cancer

We prospectively evaluated thalidomide‐induced neuropathy using electrodiagnostic studies. Sixty‐seven men with metastatic androgen‐independent prostate cancer in an open‐label trial of oral thalidomide underwent neurologic examinations and nerve conduction studies (NCS) prior to and at 3‐month inte...

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Bibliographic Details
Published in:Muscle & nerve 2001-08, Vol.24 (8), p.1050-1057
Main Authors: Molloy, F.M., Floeter, M.K., Syed, N.A., Sandbrink, F., Culcea, E., Steinberg, S.M., Dahut, W., Pluda, J., Kruger, E.A., Reed, E., Figg, W.D.
Format: Article
Language:English
Subjects:
Action Potentials - drug effects
Age Factors
Aged
Aged, 80 and over
Biological and medical sciences
Brachial Plexus - drug effects
Brachial Plexus - physiopathology
Cohort Studies
Dose-Response Relationship, Drug
Drug toxicity and drugs side effects treatment
Electrodiagnosis
Electromyography
Follow-Up Studies
Humans
Male
Medical sciences
Middle Aged
Neoplasm Metastasis
nerve conduction studies
Neural Conduction - drug effects
Neurons, Afferent - drug effects
neuropathy
Peripheral Nervous System Diseases - chemically induced
Peripheral Nervous System Diseases - diagnosis
Pharmacology. Drug treatments
Prospective Studies
Prostatic Neoplasms - drug therapy
Risk Factors
Sural Nerve - drug effects
Sural Nerve - physiopathology
thalidomide
Thalidomide - adverse effects
toxicity
Toxicity: nervous system and muscle
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Summary:We prospectively evaluated thalidomide‐induced neuropathy using electrodiagnostic studies. Sixty‐seven men with metastatic androgen‐independent prostate cancer in an open‐label trial of oral thalidomide underwent neurologic examinations and nerve conduction studies (NCS) prior to and at 3‐month intervals during treatment. NCS included recording of sensory nerve action potentials (SNAPs) from median, radial, ulnar, and sural nerves. SNAP amplitudes for each nerve were expressed as the percentage of its baseline, and the mean of the four was termed the SNAP index. A 40% decline in the SNAP index was considered clinically significant. Thalidomide was discontinued in 55 patients for lack of therapeutic response. Of 67 patients initially enrolled, 24 remained on thalidomide for 3 months, 8 remained at 6 months, and 3 remained at 9 months. Six patients developed neuropathy. Clinical symptoms and a decline in the SNAP index occurred concurrently. Older age and cumulative dose were possible contributing factors. Neuropathy may thus be a common complication of thalidomide in older patients. The SNAP index can be used to monitor peripheral neuropathy, but not for early detection. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 1050–1057, 2001
ISSN:0148-639X
1097-4598
DOI:10.1002/mus.1109