Colorectal Cancer Survivors Suffering From Sensory Chemotherapy-Induced Peripheral Neuropathy Are Not a Homogenous Group: Secondary Analysis of Patients’ Profiles With Oxaliplatin-Induced Peripheral Neuropathy

Abstract

Oxaliplatin, a pivotal drug in the management of colorectal cancer, causes chemotherapy-induced peripheral neuropathy (CIPN) in a third of cancer survivors. Based on a previous cross-sectional study assessing oxaliplatin-related sensory CIPN in colorectal cancer survivors, a secondary analysis was designed to explore the possibility that different clusters of patients may co-exist among a cohort of patients with oxaliplatin-related CIPN. Other objectives were to characterize these clusters considering CIPN severity, anxiety, depression, health-related quality of life (HRQOL), patients’ characteristics and oxaliplatin treatments. Among the 96 patients analyzed, three clusters were identified (cluster 1: 52, cluster 2: 34, and cluster 3: 10 patients). Clusters were significantly different according to CIPN severity and the proportion of neuropathic pain (cluster 1: low, cluster 2: intermediate, and cluster 3: high). Anxiety, depressive disorders and HRQOL alteration were lower in cluster 1 in comparison to clusters 2 and 3, but not different between clusters 2 and 3. This study underlines that patients with CIPN are not a homogenous group, and that CIPN severity is associated with psychological distress and a decline of HRQOL. Further studies are needed to explore the relation between clusters and CIPN management.

Potential Mediators of Oxaliplatin-Induced Peripheral Neuropathy From Adjuvant Therapy in Stage III Colon Cancer: Findings From CALGB (Alliance)/SWOG 80702

“…Although several studies have previously examined the relationship between BMI and OIPN in CRC, they have reported conflicting findings. One retrospective investigation 6 observed an inverse relationship between BMI and OIPN; however, four prospective studies [7][8][9][10] of approximately 100 patients with CRC each reported a positive correlation. In our significantly larger cohort, we similarly demonstrate that a higher BMI is associated with increased severity of CTCAEreported-although not FACT/GOG-NTX-13-measuredneuropathy.…”

“…More than 90% of patients with CRC treated with oxaliplatin may develop OIPN, 52 resulting in impairments in daily functioning, mental health, and quality of life. 8,[53][54][55] As patients with CRC comprise one of the largest groups of cancer survivors, 56 improving our understanding of preventing and managing chronic OIPN is of especially high importance. Shorter chemotherapy durations in the management of CRC have been shown to be similarly effective as longer treatments, 22,23,57 and our findings lend support for potential additional benefits through decreased chemotherapy-related toxicity and improved treatment adherence and quality of life.…”

“…Conflicting findings have been reported regarding the clinical and sociodemographic factors predisposing patients with colorectal cancer (CRC) to oxaliplatininduced peripheral neuropathy (OIPN). 1,2 Only receipt of a higher cumulative dose has consistently been associated with greater neurotoxicity, 2-5 whereas discordant findings have been reported regarding the contributions of body mass index (BMI) [6][7][8][9][10] and diabetes mellitus. [10][11][12][13][14] Nonsteroidal anti-inflammatory drug (NSAID) use, 15 physical activity, 16 and vitamin B6 17 have additionally been posited to influence OIPN in CRC, but little evidence currently exists to substantiate these hypotheses.…”

Exploring Serum Biomarkers for Neuropathic Pain in Rat Models of Chemotherapy-Induced Peripheral Neuropathy: A Comparative Pilot Study with Oxaliplatin, Paclitaxel, Bortezomib, and Vincristine

“…The primary outcome used to assess and validate CIPN in animals was the presence of nociceptive disorders, specifically tactile allodynia thresholds assessed using the electronic von Frey test. Neuropathic pain serves as a reliable marker of CIPN severity in patients [ 3 , 4 , 58 ]. Measuring nociceptive thresholds in living rodents is convenient and allows for repeatability [ 59 ].…”