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Supportive Care in Cancer

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01-12-2021 | Colon Cancer | Original Article

Neuropathy severity at the time of oxaliplatin treatment alteration in patients with colon cancer (Alliance A151912)

Authors: Daniel L. Hertz, Travis J. Dockter, Daniel V. Satele, Charles L. Loprinzi, Jennifer Le-Rademacher

Published in: Supportive Care in Cancer | Issue 12/2021

Abstract

Background

Clinical guidelines recommend altering chemotherapy treatment by decreasing, delaying, or discontinuing dosing in patients who are experiencing chemotherapy-induced peripheral neuropathy. There are few data available on the clinical use of treatment alteration including the severity of CIPN at the time of treatment alteration.

Methods

This was a retrospective analysis of patients receiving oxaliplatin on the NCCTG N08CB trial. Neuropathy severity was assessed at each cycle by clinicians and patients. Patients were classified as (1) completed treatment without alteration, (2) dose reduction or delay due to neuropathy, (3) discontinuation due to neuropathy, (4) discontinuation for other toxicity, or (5) discontinuation for another reason (5). Comparisons focused primarily on patients with alteration due to neuropathy (groups 2 and/or 3) compared with patients who completed treatment without alteration (group 1).

Results

In 350 participants, 135 (39%) completed treatment without alteration, 70 (20%) had a dose reduction or delay due to neuropathy, and 35 (10%) discontinued early due to neuropathy. Clinician-assessed neuropathy severity was greater in patients at the time of dose reduction or delay compared with severity at the end of treatment in patients without alteration (p < 0.0001). Patient-reported neuropathy severity at cycle 4 was worse in patients who eventually had a reduction or delay as compared with patients who completed treatment without alteration (p = 0.017).

Conclusions

Treatment alterations due to neuropathy are common in patients receiving oxaliplatin for colon cancer and are associated with clinician-assessed neuropathy severity. Rapid increases in patient-reported neuropathy severity indicate a potential need for monitoring and intervention.

Trial Registration

Clinicaltrials.gov Identifier: NCT01099449 (NCCTG N08CB)

Referenced from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Colon Cancer V.2.2019. © National Comprehensive Cancer Network, Inc 2019. All rights reserved. Accessed [June 27, 2019]. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

Referenced from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Rectal Cancer V.2.2019. © National Comprehensive Cancer Network, Inc 2019. All rights reserved. Accessed [July 16, 2019]. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

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Title: Neuropathy severity at the time of oxaliplatin treatment alteration in patients with colon cancer (Alliance A151912)
Authors: Daniel L. Hertz
Travis J. Dockter
Daniel V. Satele
Charles L. Loprinzi
Jennifer Le-Rademacher
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Colon Cancer
Colon Cancer
Cytostatic Therapy
Published in: Supportive Care in Cancer / Issue 12/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-021-06371-x

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Abstract

Background

Methods

Results

Conclusions

Trial Registration

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