Prevention of Oxaliplatin-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

Peng, Siyu; Ying, Ariel Fangting; Chan, Nicholas Jian Hao; Sundar, Raghav; Soon, Yu Yang; Bandla, Aishwarya

doi:10.3389/fonc.2022.731223

Cited by 9 publications

(6 citation statements)

References 89 publications

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“…This was confirmed by our results indicating that the 3M arm had significantly fewer ≥grade 3 AEs, which mainly manifested as grade 3/4 neutropenia, ≥grade 2 PSN, and ≥grade 2 HFS. PSN is one of the main dose-limiting oxaliplatin toxicities 27 , 28 and it impacts CC prognosis because it can be long-term or permanent 29 , 30 . Hence, it is critical to reduce the duration and dose of oxaliplatin.…”

Section: Discussionmentioning

confidence: 99%

Optimal duration of oxaliplatin-based adjuvant chemotherapy in patients with different risk factors for stage II–III colon cancer: a meta-analysis

Kuang,

Wang,

Liu

et al. 2024

International Journal of Surgery

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Background: The duration of oxaliplatin–based chemotherapy in high–risk stage II, low–risk stage III, and high–risk stage III colon cancer patients is controversial. To reduce the risk of adverse events (AEs) without compromising efficacy while improving chemotherapy compliance is crucial. Methods: We searched Cochrane, Embase, Pubmed, and Web of Science databases for articles from inception to 2023.8.8, the main outcomes were disease–free survival, overall survival, chemotherapy completion rates, and AE frequency. Results: Six randomized controlled trials involving 10,332 patients were included. Disease–free survival analysis revealed that only the high–risk stage III colon cancer patients experienced better results with the six–month FOLFOX regimen when compared with the 3–month regimen (Hazard ratio [HR]: 1.32, 95% CI: 1.15–1.51, P<0.0001). Overall survival analysis revealed that extending the use of FOLFOX and CAPEOX regimens did not provide survival benefits for stage III colon cancer patients (HR: 1.16, 95% CI: 0.9–1.49, and HR: 0.89, 95% CI: 0.67–1.18, P=0.40). The completion rate of the three–month oxaliplatin–based adjuvant chemotherapy regimen was significantly higher than that of the six–month regimen (Relative risk [RR]: 1.16, 95% CI: 1.06–1.27, P=0.002). Moreover, the three–month regimen had significantly lower AE rates than the six–month regimen (RR: 0.62, 95% CI: 0.57–0.68, P<0.00001), with differences mainly concentrated in grade 3/4 neutropenia (RR: 0.70, 95% CI: 0.59–0.85, P=0.0002), peripheral sensory neuropathy at≥grade 2 (RR: 0.45, 95% CI: 0.38–0.53, P<0.00001), and hand–foot syndrome at≥grade 2 (RR: 0.36, 95% CI: 0.17–0.77, P=0.009). Conclusions: The six–month FOLFOX regimen should only be recommended for high–risk stage III colon cancer, while the three–month regimen can be recommended for other stages. A three–month CAPEOX regimen can be recommended for stage II–III colon cancer.

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Section: Discussionmentioning

confidence: 99%

Optimal duration of oxaliplatin-based adjuvant chemotherapy in patients with different risk factors for stage II–III colon cancer: a meta-analysis

Kuang,

Wang,

Liu

et al. 2024

International Journal of Surgery

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“…e main therapeutic drugs in Western medicine are sodium channel blockers, calciummagnesium combination, reduced glutathione, gangliosides, and venlafaxine [68][69][70][71][72][73]. However, based on the current evidence, particularly the results of an NMA, there is insufficient certainty to support that any Western drug is effective in preventing OIPN [4]. TCMIs are the product of modernization of Chinese medicine, and compared with other herbal dosage forms, the injectable form has the characteristics of high bioavailability, precise efficacy, and rapid action, and is mostly used for preventive treatment in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…However, up to 40-50% of patients receiving this drug develop oxaliplatin-induced peripheral neurotoxicity (OIPN) [2,3]. OIPN has a clinically signi cant impact on the quality of life of patients with cancer and is a dose-limiting toxicity [4,5]. Up to 90% of patients on oxaliplatin-based regimens with doses ranging from 85 to 130 mg/m 2 will experience certain degree of acute OIPN [6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Traditional Chinese Medicine Injection in Preventing Oxaliplatin-Induced Peripheral Neurotoxicity: An Analysis of Evidence from 3598 Patients

Chen

Liu

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Oxaliplatin is an effective chemotherapeutic agent for the treatment of malignant tumors. However, severe oxaliplatin-induced peripheral neurotoxicity (OIPN) has been well documented. Traditional Chinese medicine injections (TCMIs) have shown significant efficacy in preventing OIPN. However, it is difficult for clinicians to determine the differences in the efficacy of various TCMIs in preventing OIPN. The aim of this study was to compare the efficacy of various TCMIs in preventing OIPN through a network meta-analysis (NMA) to further inform clinical decision-making. Methods. The Chinese Journal Full Text Database, Chinese Biomedical Literature Database, Wanfang Data Knowledge Service Platform, Chinese Science and Technology Journal Full Text Database, the Cochrane Library, Web of Science, PubMed, and Embase databases were searched for randomized controlled trials (RCTs) of TCMIs for OIPN prevention. The retrieval time was from the establishment of the database to April 12, 2021. NMA was performed using Stata 14.0 software after 2 evaluators independently screened the literature, extracted information, and evaluated the risk of bias of the included studies. Results. A total of 45 eligible RCTs involving 3598 cancer patients and 13 TCMIs were included. The 13 TCMIs included Xiaoaiping injection (XAPI), compound kushen injection (CKSI), Aidi injection (ADI), Brucea javanica oil emulsion injection (BJOEI), Shenmai injection (SMI), Kangai injection (KAI), Astragalus injection (AI), elemene emulsion injection (EEI), Shenfu injection (SFI), Shenqi Fuzheng injection (SIFZI), Kanglaite injection (KLEI), Huachansu injection (HCSI), and lentinan injection (LI). NMA results showed that AI was superior to AD and SIFZI was superior to ADI in reducing the incidence of grade I neurotoxicity. SIFZI was superior to EEI and ADI, and BJOEI was superior to chemotherapy alone in reducing the incidence of grade II neurotoxicity. SMI was superior to LI and CKSI in reducing the incidence of grade III neurotoxicity. SIFZI was superior to LI, BJOEI, XAPI, EEI, SMI, chemotherapy alone, HCSI, KLEI, and ADI in reducing the total incidence of grade I–IV neurotoxicity. SFI was superior to ADI. Based on the SUCRA values, AI was the most likely intervention to reduce the incidence of grade I neurotoxicity, SIFZI was the most likely intervention to reduce the total incidence of grade II and I–IV neurotoxicity, and SMI was the most likely intervention to reduce the incidence of grade III and IV neurotoxicity. Conclusion. TCMIs can prevent OIPN to some extent, among which SIFZI, SMI, and AI may be the most promising TCMIs. However, given the limitations of current studies, more well-designed, high-quality clinical trials will be needed in the future to validate the benefits of TCMIs.

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“…Furthermore, elevated apoptotic markers such as caspase-3 can be used to assess the apoptotic signalling pathway [9,10]. By scavenging free radicals and suppressing the inflammatory cascade, L-carnosine has an antioxidant and anti-inflammation effect on OPIN pathways that have been widely studied [11].…”

Section: Role Of L-carnosine In Cancermentioning

confidence: 99%

Effect of L-Carnosine in Patients with Age-Related Diseases: A Systematic Review and Meta-Analysis

Sureshkumar¹,

Durairaj²,

Srinivasan³

et al. 2023

Front. Biosci. (Landmark Ed)

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Introduction: L-carnosine has been found to have multimodal activity. Aim: The aim of this review was to find out the efficacy of Lcarnosine in patients with age-related diseases. Methods: Clinical studies evaluated the effect of L-carnosine on cancer, cardiovascular disease, diabetes, and neurodegenerative disorders were searched in electronic bibliographic databases. The protocol has been registered with PROSPERO (CRD42022314033). The revised Cochrane risk of bias tool for randomized trials was used to assess all of the reports for risk of bias. RevMan 5.4 was used to conduct the meta-analysis. Results: Following the screening process, 14 papers were selected for systematic review, with 9 of them being qualified for meta-analysis. Many of the included studies showed that L-carnosine has potential therapeutic activity in age related diseases. Results from the meta-analysis showed that in diabetes mellitus, HbA1c [mean difference (MD) 95% CI = -1.25 (-2.49, -0.022); p = 0.05; p = 0.001; I 2 = 85%] and fasting blood sugar (FBS) [MD 95% CI = -12.44 (-22.44, -2.44); p = 0.01; p = 0.40; I 2 = 0%] and in neurodegenerative disorder, Wechsler Memory Scale Logical Memory 2 (WMS-LM2) [MD 95% CI = 1.34 (0.83, 1.85); p < 0.00001; p = 0.43; I 2 = 0%], showed statistically significant difference, favoring the L-carnosine group over the control group. While in neurodegenerative disorder, Alzheimer 's Disease Assessment Scale (ADAS) [MD 95% CI = 0.98 (-1.55, -0.42); p = 0.0007; p = 0.86; I 2 = 0%] and Back Depression Inventory (BDI) [MD 95% CI = -1.12 (-1.87, -0.37); p = 0.003; p = 0.73; I 2 = 0%] showed statistically significant difference, favoring the control group over L-carnosine group. Conclusions: Clinical studies were conducted to manage chemotherapy induced toxicities and there are no clinical studies available for its anti-cancer use, and the current evidence does not support its use in the treatment of cardiovascular disease.

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Prevention of Oxaliplatin-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

Cited by 9 publications

References 89 publications

Optimal duration of oxaliplatin-based adjuvant chemotherapy in patients with different risk factors for stage II–III colon cancer: a meta-analysis

Optimal duration of oxaliplatin-based adjuvant chemotherapy in patients with different risk factors for stage II–III colon cancer: a meta-analysis

Efficacy of Traditional Chinese Medicine Injection in Preventing Oxaliplatin-Induced Peripheral Neurotoxicity: An Analysis of Evidence from 3598 Patients

Effect of L-Carnosine in Patients with Age-Related Diseases: A Systematic Review and Meta-Analysis

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