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Supportive Care in Cancer
Published in: Supportive Care in Cancer 7/2012

01-07-2012 | Original Article

Duloxetine improves oxaliplatin-induced neuropathy in patients with colorectal cancer: an open-label pilot study

Authors: Ya-Hsu Yang, Jen-Kou Lin, Wei-Shone Chen, Tzu-Chen Lin, Shung-Haur Yang, Jeng-Kai Jiang, Shih-Ching Chang, Yuan-Tzu Lan, Chun-Chi Lin, Chueh-Chuan Yen, Cheng-Hwai Tzeng, Wei-Shu Wang, Huey-Ling Chiang, Chung-Jen Teng, Hao-Wei Teng

Published in: Supportive Care in Cancer | Issue 7/2012

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Abstract

Background

This open-label pilot study is aimed to evaluate the efficacy and tolerability of the antidepressant duloxetine, which is effective for diabetic neuropathic pain, in the treatment of chronic oxaliplatin-induced peripheral neuropathy (OIPN).

Methods

We enrolled a total of 39 patients with stage III or IV colorectal cancer with chronic OIPN. They were treated with duloxetine by increasing the dose from 30 mg/day to 60 mg/day. Patients’ pain intensity was rated at baseline and 12 weeks after duloxetine administration. The severity of neuropathic pain was evaluated using the visual analog scale (VAS) score and the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 3 (NCI-CTCAE v3.0).

Results

Nine patients (23.1%) discontinued duloxetine before the end of treatment because of adverse events. Of the remaining 30 patients, 19 patients (63.3%) had a VAS score improvement. Among them, nine (47.4%) showed a simultaneous grade improvement, and the other 10 patients (52.6%) had a stable grade according to NCI-CTCAE v3.0. Treatment with duloxetine did not impair renal or liver function and did not interfere with chemotherapy.

Conclusions

Duloxetine is feasible in treating chronic OIPN with tolerable toxicity at a daily dose of 60 mg/day.
Literature
1.
2.
3.
Kim GP, Erlichman C (2007) Oxaliplatin in the treatment of colorectal cancer. Expert Opin Drug Metab Toxicol 3:281–294PubMedCrossRef
4.
de Gramont A, Figer A, Seymour M et al (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18:2938–2947PubMed
5.
Andre T, Boni C, Mounedji-Boudiaf L et al (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351PubMedCrossRef
6.
Cassidy J, Tabernero J, Twelves C et al (2004) XELOX (capecitabine plus oxaliplatin): active first-line therapy for patients with metastatic colorectal cancer. J Clin Oncol 22:2084–2091PubMedCrossRef
7.
Tournigand C, Cervantes A, Figer A et al (2006) OPTIMOX1: a randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-Go fashion in advanced colorectal cancer—a GERCOR study. J Clin Oncol 24:394–400PubMedCrossRef
8.
Wilson RH, Lehky T, Thomas RR et al (2002) Acute oxaliplatin-induced peripheral nerve hyperexcitability. J Clin Oncol 20:1767–1774PubMedCrossRef
9.
Extra JM, Marty M, Brienza S et al (1998) Pharmacokinetics and safety profile of oxaliplatin. Semin Oncol 25:13–22PubMed
10.
11.
Saif MW, Reardon J (2005) Management of oxaliplatin-induced peripheral neuropathy. Ther Clin Risk Manag 1:249–258PubMed
12.
Wolf S, Barton D, Kottschade L et al (2008) Chemotherapy-induced peripheral neuropathy: prevention and treatment strategies. Eur J Cancer 44:1507–1515PubMedCrossRef
13.
Cathomas R, Koberle D, Ruhstaller T et al (2010) Heated (37 degrees C) oxaliplatin infusion in combination with capecitabine for metastatic colorectal carcinoma: can it reduce neuropathy? Support Care Cancer 18:1263–1270PubMedCrossRef
14.
Detke MJ, Lu Y, Goldstein DJ et al (2002) Duloxetine, 60 mg once daily, for major depressive disorder: a randomized double-blind placebo-controlled trial. J Clin Psychiatry 63:308–315PubMedCrossRef
15.
Goldstein DJ, Mallinckrodt C, Lu Y et al (2002) Duloxetine in the treatment of major depressive disorder: a double-blind clinical trial. J Clin Psychiatry 63:225–231PubMedCrossRef
16.
Goldstein DJ, Lu Y, Detke MJ et al (2004) Duloxetine in the treatment of depression: a double-blind placebo-controlled comparison with paroxetine. J Clin Psychopharmacol 24:389–399PubMedCrossRef
17.
Goldstein DJ, Lu Y, Detke MJ et al (2005) Duloxetine vs. placebo in patients with painful diabetic neuropathy. Pain 116:109–118PubMedCrossRef
18.
Wernicke JF, Pritchett YL, D’Souza DN et al (2006) A randomized controlled trial of duloxetine in diabetic peripheral neuropathic pain. Neurology 67:1411–1420PubMedCrossRef
19.
Raskin J, Pritchett YL, Wang F et al (2005) A double-blind, randomized multicenter trial comparing duloxetine with placebo in the management of diabetic peripheral neuropathic pain. Pain Med 6:346–356PubMedCrossRef
20.
Price DD, McGrath PA, Rafii A et al (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56PubMedCrossRef
21.
Aun C, Lam YM, Collett B (1986) Evaluation of the use of visual analogue scale in Chinese patients. Pain 25:215–221PubMedCrossRef
22.
Trotti A, Colevas AD, Setser A et al (2003) CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol 13:176–181PubMedCrossRef
23.
Greene FL (2002) The American Joint Committee on Cancer: updating the strategies in cancer staging. Bull Am Coll Surg 87:13–15PubMed
24.
Metzger U (1990) Adjuvant therapy for colon and rectal cancer. NIH Consensus Development Conference. Eur J Cancer 26:753–755PubMedCrossRef
25.
Benson AB 3rd, Schrag D, Somerfield MR et al (2004) American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol 22:3408–3419PubMedCrossRef
26.
Kuebler JP, Wieand HS, O’Connell MJ et al (2007) Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol 25:2198–2204PubMedCrossRef
27.
Tesfaye S (2009) Advances in the management of diabetic peripheral neuropathy. Curr Opin Support Palliat Care 3:136–143PubMedCrossRef
28.
Grolleau F, Gamelin L, Boisdron-Celle M et al (2001) A possible explanation for a neurotoxic effect of the anticancer agent oxaliplatin on neuronal voltage-gated sodium channels. J Neurophysiol 85:2293–2297PubMed
29.
Ta LE, Espeset L, Podratz J et al (2006) Neurotoxicity of oxaliplatin and cisplatin for dorsal root ganglion neurons correlates with platinum-DNA binding. Neurotoxicology 27:992–1002PubMedCrossRef
30.
Schmeichel AM, Schmelzer JD, Low PA (2003) Oxidative injury and apoptosis of dorsal root ganglion neurons in chronic experimental diabetic neuropathy. Diabetes 52:165–171PubMedCrossRef
31.
Willis WD, Coggeshall RE (1991) Sensory mechanisms of the spinal cord. Plenum, New York
32.
Basbaum AI, Fields HL (1984) Endogenous pain control systems: brainstem spinal pathways and endorphin circuitry. Annu Rev Neurosci 7:309–338PubMedCrossRef
33.
Suzuki R, Rygh LJ, Dickenson AH (2004) Bad news from the brain: descending 5-HT pathways that control spinal pain processing. Trends Pharmacol Sci 25:613–617PubMedCrossRef
34.
Coderre TJ, Katz J (1997) Peripheral and central hyperexcitability: differential signs and symptoms in persistent pain. Behav Brain Sci 20:404–419, discussion 435–513PubMed
35.
36.
Iyengar S, Webster AA, Hemrick-Luecke SK et al (2004) Efficacy of duloxetine, a potent and balanced serotonin-norepinephrine reuptake inhibitor in persistent pain models in rats. J Pharmacol Exp Ther 311:576–584PubMedCrossRef
37.
Stahl SM, Grady MM, Moret C et al (2005) SNRIs: their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants. CNS Spectr 10:732–747PubMed
38.
Rowbotham MC, Goli V, Kunz NR et al (2004) Venlafaxine extended release in the treatment of painful diabetic neuropathy: a double-blind, placebo-controlled study. Pain 110:697–706PubMedCrossRef
39.
Bymaster FP, Dreshfield-Ahmad LJ, Threlkeld PG et al (2001) Comparative affinity of duloxetine and venlafaxine for serotonin and norepinephrine transporters in vitro and in vivo, human serotonin receptor subtypes, and other neuronal receptors. Neuropsychopharmacology 25:871–880PubMedCrossRef
40.
Brannan SK, Mallinckrodt CH, Brown EB et al (2005) Duloxetine 60 mg once-daily in the treatment of painful physical symptoms in patients with major depressive disorder. J Psychiatr Res 39:43–53PubMedCrossRef
41.
Jin Y, Desta Z, Stearns V et al (2005) CYP2D6 genotype, antidepressant use, and tamoxifen metabolism during adjuvant breast cancer treatment. J Natl Cancer Inst 97:30–39PubMedCrossRef
42.
Bosch TM, Meijerman I, Beijnen JH et al (2006) Genetic polymorphisms of drug-metabolising enzymes and drug transporters in the chemotherapeutic treatment of cancer. Clin Pharmacokinet 45:253–285PubMedCrossRef
43.
Hewes JC, Riddy D, Morris RW et al (2006) A prospective study of isolated human hepatocyte function following liver resection for colorectal liver metastases: the effects of prior exposure to chemotherapy. J Hepatol 45:263–270PubMedCrossRef
44.
Masek V, Anzenbacherova E, Machova M et al (2009) Interaction of antitumor platinum complexes with human liver microsomal cytochromes P450. Anticancer Drugs 20:305–311PubMedCrossRef
45.
Hanioka N, Ozawa S, Jinno H et al (2002) Interaction of irinotecan (CPT-11) and its active metabolite 7-ethyl-10-hydroxycamptothecin (SN-38) with human cytochrome P450 enzymes. Drug Metab Dispos 30:391–396PubMedCrossRef
46.
Park JY, Kim KA (2003) Inhibitory effect of 5-fluorouracil on human cytochrome P(450) isoforms in human liver microsomes. Eur J Clin Pharmacol 59:407–409PubMedCrossRef
Metadata
Title
Duloxetine improves oxaliplatin-induced neuropathy in patients with colorectal cancer: an open-label pilot study
Authors
Ya-Hsu Yang
Jen-Kou Lin
Wei-Shone Chen
Tzu-Chen Lin
Shung-Haur Yang
Jeng-Kai Jiang
Shih-Ching Chang
Yuan-Tzu Lan
Chun-Chi Lin
Chueh-Chuan Yen
Cheng-Hwai Tzeng
Wei-Shu Wang
Huey-Ling Chiang
Chung-Jen Teng
Hao-Wei Teng
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 7/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-011-1237-2

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