Capecitabine combined with oxaliplatin (CapOx) in clinical practice: how significant is peripheral neuropathy?

Storey, Dawn J; Sakala, Michelle D.; McLean, Catriona; Phillips, H.A.; Dawson, L.; Wall, Lucy; Fallon, Marie; Clive, Sally

doi:10.1093/annonc/mdp594

Cited by 49 publications

(63 citation statements)

References 18 publications

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“…In the current setting, the reported rate of patients who manifested acute (85.9%) and chronic (72.4%) OXLIPN after either FOLFOX or XELOX was quite similar to that previously reported 17, 18. The symptoms of acute toxicity are different from those of chronic toxicity.…”

Section: Discussionsupporting

confidence: 90%

Clinical pattern and associations of oxaliplatin acute neurotoxicity

Cavaletti

Briani

Velasco

et al. 2012

Cancer

189

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BACKGROUND:The objective of the current prospective, multicenter, international study was to trace the incidence and severity of acute oxaliplatin-induced peripheral neuropathy (OXLIPN) and to determine its clinical pattern. The authors also specifically tested whether patients who had more symptoms of acute OXLIPN eventually would develop a more severe chronic, cumulative form of OXLIPN. METHODS: One hundred seventy patients (mean AE standard deviation age, 63.7 AE 8.7 years) who were scheduled to receive either combined leucovorin, 5-fluoruracil, and oxaliplatin (FOLFOX) or combined capecitabine and oxaliplatin (XELOX) for metastatic colorectal cancer were monitored prospectively at baseline and were followed in 4 European sites. The incidence of hyperexcitability symptoms secondary to acute OXLIPN was assessed by using a descriptive questionnaire (yes/no question) at each clinical evaluation. Motor and neurosensory criteria according to version 3 of the National Cancer Institute's Common Toxicity Criteria were applied to clinically grade the severity of OXLIPN. RESULTS: Acute OXLIPN was present in 146 of 170 patients (85.9%). The vast majority of these patients manifested cold-induced perioral (95.2%) or pharyngolaryngeal (91.8%) dysesthesias. Severe acute OXLIPN that required prolongation of oxaliplatin infusion from 2 hours to 4 to 6 hours occurred in 32 of 146 patients (21.9%). The increased number of acute OXLIPN symptoms was correlated significantly (Spearman rho correlation coefficient [r]) with both the development (r ¼ 0.602; P < .001) and the degree of the chronic, cumulative form (r ¼ 0.702; P < .001). CONCLUSIONS: The current results indicated that the vast majority of patients with colorectal cancer who receive oxaliplatin-based chemotherapy will manifest symptoms of a transient acute syndrome soon after oxaliplatin administration. Patients who have a more complex combination of acute phenomena related to axonal hyperexcitability are those who eventually develop more severe OXLIPN. Therefore, it may be advisable to test agents against acute OXLIPN to verify their effects on the chronic form. Cancer 2013;119:438-44. V C 2012 American Cancer Society.KEYWORDS: oxaliplatin, neurotoxicity, acute neuropathy, hyperexcitability, peripheral nerve damage. INTRODUCTIONColorectal cancer (CRC) represents the third most common type of cancer and the second leading cause of cancer-related deaths in the Western world. 1 Therapeutic management of CRC is challenging and depends on the disease stage at diagnosis. Current knowledge indicates that oxaliplatin (OXL)-based combination regimens, in the form of either combined leucovorin, 5-fluoruracil, and OXL (FOLFOX) or combined capecitabine and OXL (XELOX), have demonstrated substantial cytotoxic synergy in the adjuvant setting and in the advanced or metastatic setting and, thus, are associated with prolonged disease progression-free and overall survival. 2 However, peripheral neuropathy is currently recognized as 1 of the major nonhematologic toxicities of OXL with a...

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Section: Discussionsupporting

confidence: 90%

Clinical pattern and associations of oxaliplatin acute neurotoxicity

Cavaletti

Briani

Velasco

et al. 2012

Cancer

189

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“…Previous studies have demonstrated that the risk of developing neuropathy increases with escalating cumulative doses and cycles of chemotherapy [41–43]. This study suggests that the risk of falls increases with cumulative doses and chemotherapy cycles and that persons with higher peripheral neuropathy scores are at higher risk of falls.…”

Section: Discussionsupporting

confidence: 51%

Falls in persons with chemotherapy-induced peripheral neuropathy

Tofthagen

Overcash

Kip

2011

Support Care Cancer

196

119

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“…In contrast to the previous study, which evaluated patients 1–7 years after the completion of C/T, the present study evaluated patients during C/T (Tofthagen, McMillan, et al, ). Similar to previous studies (Storey et al, ; Ventzel, Jensen, Jensen, Jensen, & Finnerup, ), this study found that acute OXAIPN mainly developed during the interval between three and nine or more cycles of C/T and subsequently evolved into chronic OXAIPN. The earliest OXAIPN symptom to emerge was the numbness of the upper/lower extremities (87.5% vs. 76.8% respectively), similar to rates reported in previous studies (45.9%–77.4%), with the numbness gradually spreading to affect the lower extremities (Lu, ; Park et al, ; Stefansson & Nygren, ).…”

Section: Discussionsupporting

confidence: 90%

Incidence, severity, longitudinal trends and predictors of acute and chronic oxaliplatin‐induced peripheral neuropathy in Taiwanese patients with colorectal cancer

et al. 2018

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The purpose of this study was to evaluate the longitudinal incidence, severity, pattern of changes or predictors of oxaliplatin‐induced peripheral neuropathy (OXAIPN) in Taiwanese patients with colorectal cancer. A longitudinal repeated measures study design was employed, and 77 participants were recruited from the colorectal and oncology departments of two teaching medical centres in Taiwan. Physical examinations were performed, and self‐reports regarding adverse impacts of OXAIPN and quality of life were obtained at five time points throughout 12 cycles of chemotherapy (C/T). The incidence of OXAIPN increased with C/T cycles (31.1%–81.9%), and the upper limb numbness and cold sensitivity were most significant acute OXAIPN symptoms (29.9%–73.6%). Findings also documented significant increases in overall severity, symptom distress, interference and physical results associated with OXAIPN over the course of C/T. Predictors of OXAIPN severity varied by treatment cycle, including younger patient, higher cumulative dose of oxaliplatin, greater body surface area, receipt of chemotherapy in winter and the occurrence of OXAIPN during prior C/T cycles. The results from this study might help healthcare providers to recognise the symptom characteristics, degree of influences, trends and high‐risk group of OXAIPN, facilitating early evaluation and potential interventions to mitigate or prevent negative effects of OXAIPN on patients.

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Capecitabine combined with oxaliplatin (CapOx) in clinical practice: how significant is peripheral neuropathy?

Abstract: Incidence of acute PN during CapOx appears similar to FOLFOX4 but chronic PN in adjuvant patients may be more common with CapOx.

Cited by 49 publications

References 18 publications

Clinical pattern and associations of oxaliplatin acute neurotoxicity

Clinical pattern and associations of oxaliplatin acute neurotoxicity

Falls in persons with chemotherapy-induced peripheral neuropathy

Incidence, severity, longitudinal trends and predictors of acute and chronic oxaliplatin‐induced peripheral neuropathy in Taiwanese patients with colorectal cancer

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