FOLFIRINOX-induced reversible dysarthria: A case report and review of previous cases

Matsuoka, Ayumu; Maeda, Osamu; Inada‐Inoue, Megumi; Ohno, Eizaburo; Hirooka, Yoshiki; Yokoyama, Yukihiro; Fujii, Tsutomu; Nagino, Masato; Goto, Hidemi; Ando, Yumiko

doi:10.3892/ol.2015.3591

Cited by 7 publications

(20 citation statements)

References 19 publications

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“…To date, 29 cases of transient dysarthria and/ or aphasia observed during or shortly following the administration of irinotecan have been reported in the literature and are summarized in Table 1 [12][13][14][15][16][17][18][19][20][21]27].…”

Section: Discussionmentioning

confidence: 99%

“…In all reported cases [12][13][14][15][16][17][18][19][20][21], clinical signs were stable and neurological examinations showed no evidence of neurological abnormalities, except dysarthria. Patients were monitored carefully and observed to return close to their baseline status within 1-2 h.…”

Section: Discussionmentioning

confidence: 99%

“…Co-administration of atropine 0.2 mg administered subcutaneously may prevent these adverse reactions. Some central nervous system (CNS) adverse events related to CPT-11 have also been described, including dysarthria and/or aphasia, and to date only 29 cases have been reported in the literature [12][13][14][15][16][17][18][19][20][21]27] (Table 1). The mechanism of CPT-11-related neurological toxicity is not completely understood.…”

Section: Introductionmentioning

confidence: 99%

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Irinotecan-Induced Transient Dysarthria: Case Series and Updated Literature Review

et al. 2020

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Irinotecan-based regimens are used worldwide for the treatment of several recurrent or advanced gastrointestinal malignancies. In this paper we describe the cases of four patients treated in our institution who developed acute dysarthria while receiving intravenous infusion of irinotecan. In all our cases, dysarthria occurred during the infusion of the first course of irinotecan, and then resolved rapidly without any sequelae. Imaging of the brain was performed, but failed to show any evidence of an acute neurological event. We also reviewed the literature on this very uncommon adverse event. The pathogenesis of irinotecan-induced dysarthria is still unknown and is not completely elucidated by the current pharmacodynamic or kinetic explanations; therefore, we could only hypothesize some assumptions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Irinotecan-Induced Transient Dysarthria: Case Series and Updated Literature Review

et al. 2020

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“…MRI is commonly performed but rarely yields additional information. The measures described in the literature to alleviate this symptomatology are shown in Table 1 [8,9,11,[14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Temporary Dysarthria Induced by Irinotecan-Case Report of This Rare Adverse Event

Landgraf¹,

Bognar²,

Guerra³

et al. 2017

JPP

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Abstract:This report describes the case of a patient with dysarthria during the administration of the third cycle of Folfiri for the treatment of metastatic colon cancer. After a thorough neurological examination and neuroimaging, structural causes were excluded and thus the dysarthria was attributed to the irinotecan infusion. A slowing down of the infusion rate to 180 min during the 15 subsequent cycles led to the cessation of the episodes of dysarthria. In 2016, it was estimated there will be 134,490 new cases of colorectal cancer with a five-year survival rate of 21% among patients with metastatic disease. As Irinotecan is often part of the therapeutic regimen in such cases, both in the first and second-line setting, there is a need to report rare adverse outcomes in order to find out ways to better manage of these events. The mechanism by which Irinotecan causes dysarthria is unknown and further research in this area is warranted.

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“…Transient dysarthria and blepharospasm are rare toxicities of irinotecan infusion, first recognized during the FOLFIRINOX infusion by Gunturu et al 49 Japanese investigators observed no cases of dysarthria in clinical trials of FOLFOXIRI in advanced colorectal cancer. 50 In this regimen, irinotecan is administered prior to oxaliplatin. They suggested that the FOLFIRINOX-induced dysarthria may be associated with the sequence of drug administration: intravenous infusion of oxaliplatin, immediately followed by leucovorin, followed by 30 min irinotecan.…”

Section: Management Of Toxicitiesmentioning

confidence: 99%

Current status on the place of FOLFIRINOX in metastatic pancreatic cancer and future directions

Lambert

Gavoille

Conroy

2017

Therap Adv Gastroenterol

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Pancreatic cancer (PC) incidence rates are rapidly increasing in developed countries, with half the patients being metastatic at diagnosis. For decades, fluorouracil, then gemcitabine regimens were the preferred palliative first-line options for fit patients with metastatic PC. FOLFIRINOX (a combination of bolus and infusional fluorouracil, leucovorin, irinotecan and oxaliplatin) was introduced to clinical practice in 2010 due to the results of the phase II/III trial (PRODIGE 4/ACCORD 11) comparing FOLFIRINOX with singleagent gemcitabine as first-line treatment for patients with MPC. Median overall survival, progression-free survival, and objective response rate were superior with FOLFIRINOX over gemcitabine and there was prolonged time to definitive deterioration in quality of life. Although FOLFIRINOX was also associated with increased toxicity, mainly febrile neutropenia and diarrhea, there has been rapid uptake of this regimen. This review closely examines optimal management and prevention of toxicities, international recommendations for firstline treatment, and use of modified FOLFIRINOX protocols. In this review, we also look at the potential benefit of FOLFIRINOX in selected groups of patients: second-line therapy, adjuvant chemotherapy, induction therapy in patients with borderline resectable and locally advanced PC. Robust validation of the FOLFIRINOX regimen in these settings requires confirmation in further randomized trials.

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FOLFIRINOX-induced reversible dysarthria: A case report and review of previous cases

Cited by 7 publications

References 19 publications

Irinotecan-Induced Transient Dysarthria: Case Series and Updated Literature Review

Irinotecan-Induced Transient Dysarthria: Case Series and Updated Literature Review

Temporary Dysarthria Induced by Irinotecan-Case Report of This Rare Adverse Event

Current status on the place of FOLFIRINOX in metastatic pancreatic cancer and future directions

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