Rechallenge with oxaliplatin and peripheral neuropathy in colorectal cancer patients

• Published in: Journal of cancer research and clinical oncology 2018-09, Vol.144 (9), p.1793-1801
• Main Authors: Besora, Sarah, Santos, Cristina, Izquierdo, Cristina, Martinez-Villacampa, Maria Mercedes, Bruna, Jordi, Velasco, Roser
• Format: Article
• Language: English
• Subjects: Cancer Research; Chemotherapy; Colorectal cancer; Colorectal carcinoma; Hematology; Internal Medicine; Medicine; Medicine & Public Health; Nerve conduction; Oncology; Original Article – Clinical Oncology; Oxaliplatin; Patients; Peripheral neuropathy; Toxicity
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-018-2691-8

Background Oxaliplatin (OXA) is a cornerstone in the treatment of colorectal cancer (CRC). Retreatment with OXA is frequently considered as salvage treatment. OXA-induced neuropathy (OIN) is the most frequent and feared long-term side effect. Patients and methods CRC patients receiving at least twice OXA-based chemotherapy lines at our institution between June 2000 and July 2016 were reviewed. The aim of this study was to investigate whether retreatment with OXA increases the risk of developing new or worsening previous neuropathy. OIN was assessed by National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI), Total Neuropathy Score© (TNS) and nerve-conduction studies. Results 106 patients were included in the analysis. Median age at OXA-based retreatment was 61.5 (20–83) years. After the first OXA-based chemotherapy treatment, 63.4% of patients developed OIN, 30.7 and 8.9% grades 2 and 3, respectively, after a median of 11 (1–17) cycles. After 30 (11–90) months of median to retreatment with a median of 8 (1–14) OXA cycles, 39.6, 22.6, and 0% of patients developed grade 1, 2, and 3 OIN, respectively. Worsening of the previous OIN was observed in one-third (31.1%) of all patients. OXA-cumulative dose was independently associated with greater risk of worsening OIN ( p