Paclitaxel neurotoxicity: clinical and neurophysiological study of 23 patients

Pace, Andrea; Bove, Loredana; Aloe, A.; Nardi, Mario; Pietrangeli, A; Calabresi, F.; Innocenti, P.; Jandolo, B.

doi:10.1007/bf01999566

Cited by 29 publications

(15 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Depending on the taxane used, neuropathy incidence ranges from 11% to 87%, the highest rates of which are reported for paclitaxel (Park et al., 2014; Scripture, Figg, & Sparreboom, 2006). Neurological symptoms include paresthesias and dysesthesias of toes, finger numbness, and loss of dexterity (Pace et al., 1997). Using electrophysiological techniques, patients were predominately diagnosed with moderate axonal sensory neuropathy; however, rare cases of sensorimotor polyneuropathy and carpal tunnel syndrome were observed as well (Vahdat et al., 2001).…”

Section: Taxanesmentioning

confidence: 99%

Chemotherapy‐induced neuropathies—a growing problem for patients and health care providers

2016

View full text Add to dashboard Cite

IntroductionChemotherapy‐induced neuropathies are one of the most common side effects of cancer treatment, surpassing bone marrow suppression and kidney dysfunction. Chemotherapy effects on the nervous system vary between different classes of drugs and depend on specific chemical and physical properties of the drug used. The three most neurotoxic classes of anti‐cancer drugs are: platinum‐based drugs, taxanes, and thalidomide and its analogs; other, less neurotoxic but also commonly used drugs are: bortezomib, ixabepilone, and vinca alkaloids.MethodsHere, in this paper, based on our experience and current knowledge, we provide a short review of the most common, neuropathy‐inducing anti‐cancer drugs, describe the most prevalent neuropathy symptoms produced by each of them, and outline preventive measures and treatment guidelines for cancer patients suffering from neuropathy and for their health care providers.ResultsPatients should be encouraged to report any signs of neuropathic pain, alteration in sensory perception, tingling, numbness, burning, increased hot/cold sensitivity and motor dysfunctions as early as possible. If known neurotoxic chemotherapeutics are used, a neurological examination with electrophysiological evaluation should be implemented early in the course of treatment so, both patients and physicians would be better prepared to cope with possible neurotoxic effects.ConclusionsThe use of neurotoxic chemotherapeutics should be closely monitored and if clinically permitted, that is, if a patient shows signs of cancer regression, drug doses should be reduced or combined with other less neurotoxic anti‐cancer medication. If not counteractive, the use of over the counter antineuropathic supplements such as calcium or magnesium might be encouraged. If physically possible, patients should also be encouraged to exercise regularly and avoid factors that might increase nerve damage such as excessive drinking, smoking, or sitting in a cramped position.

show abstract

Section: Taxanesmentioning

confidence: 99%

Chemotherapy‐induced neuropathies—a growing problem for patients and health care providers

2016

View full text Add to dashboard Cite

show abstract

“…The neurotoxicity is dose-and infusion-duration related, and most frequently occurs when the dose of paclitaxel per administration exceeds 250 mg/m 2 infused over 24 hours [10,12,22]. Early on, infusion related reactions and neutropenia were the most common adverse effects seen with the use of paclitaxel.…”

Section: Clinical Paclitaxel-mediated Neurotoxi-citymentioning

confidence: 99%

“…With the use of granulocyte colony-stimulating factors given in combination with paclitaxel, neurotoxicity becomes the dose-limiting toxicity [23]. The risk of developing neuropathy following treatment with paclitaxel is greater for patients who have preexisting conditions that may cause neuropathy (such as diabetes or kidney disease) or who have been previously treated with other neurotoxic chemotherapy such as cisplatin and vincristine [22].…”

Section: Clinical Paclitaxel-mediated Neurotoxi-citymentioning

confidence: 99%

Peripheral Neuropathy Induced by Paclitaxel: Recent Insights and Future Perspectives

Scripture

Figg²,

Sparreboom³

2006

273

181

View full text Add to dashboard Cite

Abstract:Paclitaxel is an antineoplastic agent derived from the bark of the western yew, Taxus brevifolia, with a broad spectrum of activity. Because paclitaxel promotes microtubule assembly, neurotoxicity is one of its side effects. Clinical use of paclitaxel has led to peripheral neuropathy and this has been demonstrated to be dependent upon the dose administered, the duration of the infusion, and the schedule of administration. Vehicles in the drug formulation, for example Cremophor in Taxol ® , have been investigated for their potential to induce peripheral neuropathy. A variety of neuroprotective agents have been tested in animal and clinical studies to prevent paclitaxel neurotoxicity. Recently, novel paclitaxel formulations have been developed to minimize toxicities. This review focuses on recent advances in the etiology of paclitaxel-mediated peripheral neurotoxicity, and discusses current and ongoing strategies for amelioration of this side effect.

show abstract

“…For each of these drug classes, the severity of neurotoxicity is determined by the dose per cycle, the cumulative dose, and the dose intensity (2). Platinum compounds affect sensory fibers with little or no involvement of motor fibers (3). At doses between 50 and 75 mg/m 2 and a cumulative dose exceeding 300 mg/m 2 , the incidence of neuropathy with cisplatin is 24% to 92% (2).…”

Section: Introductionmentioning

confidence: 99%

A Randomized, Double-Blinded, Placebo-Controlled Phase II Trial of Recombinant Human Leukemia Inhibitory Factor (rhuLIF, Emfilermin, AM424) to Prevent Chemotherapy-Induced Peripheral Neuropathy

Davis

Kiers

MacGregor

et al. 2005

Clinical Cancer Research

View full text Add to dashboard Cite

Purpose: To determine whether recombinant human leukemia inhibitory factor (rhuLIF, AM424, emfilermin) can prevent or ameliorate the development of chemotherapyinduced peripheral neuropathy (CIPN) after treatment with carboplatin (AUC 6) and paclitaxel (175 mg/m 2 over 3 hours). Experimental Design: Randomized double-blind placebo-controlled phase II clinical trial. Eligible patients had solid tumors for which treatment with carboplatin/paclitaxel was appropriate. The primary end point was a standardized composite peripheral nerve electrophysiology (CPNE) score, based on nerve velocities and amplitudes, measured at baseline and after four cycles of chemotherapy. Secondary efficacy end points included CPNE score at last cycle and at exit evaluation, vibration perception threshold, H-reflex latency, symptom scores, and quantitative assessment of neurologic signs. Study drug was given s.c. daily for 7 days starting the day before chemotherapy. Patients were randomized to receive low-dose rhuLIF (2 Mg/kg), high-dose rhuLIF (4 Mg/kg), or placebo.Results: Patients (n = 117) were randomized across seven neurology test centers. Thirty-six patients received low dose rhuLIF (2 Mg/kg), 39 received high dose rhuLIF (4 Mg/kg) and 42 received placebo. rhuLIF was well tolerated with 95% compliance and no adverse effects on quality of life. No differences between groups in CPNE or any of the individual neurologic testing variables were observed between baseline and cycle 4 or by the secondary efficacy variables.Conclusions: rhuLIF is not effective in preventing CIPN caused by carboplatin and paclitaxel. CPNE is a reliable and valid tool that was sensitive to the onset and progression of CIPN.

show abstract

Paclitaxel neurotoxicity: clinical and neurophysiological study of 23 patients

Cited by 29 publications

References 23 publications

Chemotherapy‐induced neuropathies—a growing problem for patients and health care providers

Chemotherapy‐induced neuropathies—a growing problem for patients and health care providers

Peripheral Neuropathy Induced by Paclitaxel: Recent Insights and Future Perspectives

A Randomized, Double-Blinded, Placebo-Controlled Phase II Trial of Recombinant Human Leukemia Inhibitory Factor (rhuLIF, Emfilermin, AM424) to Prevent Chemotherapy-Induced Peripheral Neuropathy

Contact Info

Product

Resources

About