Electronic von Frey as an objective assessment tool for oxaliplatin‐induced peripheral neuropathy: A prospective longitudinal study

Abstract

Objective There is wide discrepancy on how to perform clinical assessment of oxaliplatin‐induced peripheral neuropathy. In this scenario, the Electronic von Frey (EVF), which evaluates pain objectively based upon mechanical pain thresholds (MPTs), may be a valuable tool. The present study aims to quantify hyperalgesia in the hands and feet of patients treated with oxaliplatin and to propose a novel method to classify the degree of neurotoxicity using EVF‐derived measures as cut‐off points. Methods This is a prospective cohort study including 46 patients treated for colorectal cancer with the FLOX regimen. Before each oxaliplatin administration, patients were evaluated with the Acute and Chronic Neuropathy Questionnaire, Oxaliplatin‐Specific Neurotoxicity Scale and National Cancer Institute Common Terminology Criteria for Adverse Events scale. Also, objective pain assessment with the EVF was performed. Results For both upper and lower extremities, EVF was shown to correlate well with patients' symptoms and functional impairment, as assessed by subjective scales. Also, when cut‐off MPT variations were determined for diagnosis of neurotoxicity grade 2 or 3, the method showed good sensitivity and specificity. Conclusion Electronic von Frey is a noninvasive and easy‐to‐perform objective method with potential to supplement the current assessment tools for oxaliplatin‐induced peripheral neuropathy, which are mostly subjective.

A New Manganese Superoxide Dismutase Mimetic Improves Oxaliplatin-Induced Neuropathy and Global Tolerance in Mice

“…Chronic oxaliplatin-induced peripheral neuropathy was assessed with a Von Frey Test [ 33 , 54 , 55 ]. The Von Frey test assesses chronic hypoesthesia induced by oxaliplatin peripheral neuropathy.…”

Gastrointestinal Cancers and Personalized Medicine

“…The situation in stage III appears more complex. In a study on patients included in a randomized trial on adjuvant 5-FU plus Oxaliplatin and folinic acid (FOLFOX) after resection of stage III CRC, Sinicrope et al found that KRAS and BRAF mutations had a negative prognostic effect on disease-free survival, while MSI was not prognostic in all patients but significantly interacted with the tumor site and nodal status [78]. Accordingly, only patients with right-sided MSI CRC had a better outcome, and such an advantage was lost in those with N2 tumors [78].…”

“…Quantitative sensory testing (QST) examines subjective sensory function by measuring the abnormal detection and pain thresholds to several sensory modalities. The usefulness of these non-invasive psychophysical measurements in the clinic setting for detecting subclinical neurologic changes early on to identify patients that will experience OXAIPN has been largely explored [12,20,20,42,51,53,54,56,[75][76][77][78][79][80][81][82].…”

Predictive Biomarkers of Oxaliplatin-Induced Peripheral Neurotoxicity

“…Quantitative sensory testing (QST) examines subjective sensory function by measuring the abnormal detection and pain thresholds to several sensory modalities. The usefulness of these non-invasive psychophysical measurements in the clinic setting for detecting subclinical neurologic changes early on to identify patients that will experience OXAIPN has been largely explored [ 12 , 20 , 20 , 42 , 51 , 53 , 54 , 56 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ].…”

“…Touch threshold changes became statistically significant in the fingertips at middle and 8 chemotherapy doses [ 42 ] whereas these findings only occurred after treatment completion in Kroigard’s study [ 60 ]. Very recently, electronic von Frey anaesthesiometer, which evaluates hyperalgesia based upon mechanical pain thresholds (MDTs), was tested prospectively in 46 CRC patients treated with OXA, and showed a decrease of 40 g in the MDT of both hands and feet as cut-off for diagnosing grade 2 or 3 OXAIPN with a total accuracy of 84.2% and 81.6% in hands and feet, respectively [ 78 ]. Besides diagnostic utility, the role MDT changes for predicting OXAIPN requires further research.…”