Abstracts

Abstract

Chemotherapy Induced Peripheral Neurotoxicity (CIPN), a sensory polyneuropathy or neuronopathy, is a common adverse event of anticancer drugs. CIPN is a long lasting or permanent adverse event for which no clearly effective treatments exist. This unmet clinical need is in part due to the absence of a gold standard for CIPN assessment in clinical trials. The ideal outcome measure is still a matter of debate. In the present study we propose a close and formal longitudinal monitoring of patients before and after treatment.Data from 155 subjects were available for analysis. Neurological assessment was done with the clinical version of the Total Neuropathy Score© (cTNS©) scale, and patients' point of view was assessed via FACT-GOG-Ntx questionnaire (items 29-39 of the whole FACT-GOG scale). Data were collected at baseline and at chemotherapy completion. Only data from subjects with no evidence of neuropathy at baseline are included in this analysis.Eighty-five percent of subjects were female; 50% were treated with taxanes, 28% with platinum-drugs and 22% with a combination of both. At the end of treatment, 12% did not develop neuropathy, 68% showed a grade I neuropathy, and 20% a grade II neuropathy.Overall, FACT-GOG-Ntx items that showed an association with TNS© deterioration at the end of treatment were: 29 30, 31, 32, 37, 38 (p<0.001); a direct relationship was also observed between TNS© score and FACT-GOG-Ntx median number of pathological items (<0.001). When stratifying for drug classes, these FACT-GOG-Ntx items showed a similar association: for taxanes items 29, 30, 31, 32, 37; for platinum-drugs items 29, 31, 32, 37, 28; for the combination items 29, 39, 31, 32, 37, 38. Our well described population confirmed that CIPN develops in a consistent proportion of cancer patients, being potentially detrimental for cancer survivors' Quality of Life. Our data support previous findings (Huang et al. 2007) that the first 4 FACT-GOG-Ntx items (29 [numbness/tingling in hands)], 30 [numbness/tingling in feet], 31 [disconfort in hands], 32[disconfort in hands])the "sensory subscale" can detect alterations of QoL according to neurological deterioration. These observations might be relevant for future neuroprotection trial designs and interpretation. **This contribution is presented on the behalf of the CI-PeriNomS goup "Validation and reduction of FACT/GOG-Ntx subscale for platinum/paclitaxel-induced neurologic symptoms: a gynecologic oncology group study" by Huang et al. 2007. A 68-year-old man was admitted to our ward due to the appearance, 4 days previously, of progressively worsening dysphagia and dysarthria with impaired gait and coordination. He had been diagnosed with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in 2008 and treated with intravenous Immunoglobulin (IVIG) with a good response. His past medical history was positive for the occurrence of lateral gaze diplopia in 2003, prompting a brain MRI which revealed punctiform lesions on T2 in the right mesencephalon; treatment was started with aspirin, fol...