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[Treatment algorithm for oxaliplatin-induced peripheral neuropathy].

Satoru Nihei1, Junya Sato, Toshimoto Kimura

  • 1Dept. of Pharmacy, Iwate Medical University Hospital.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|December 2, 2014
PubMed
Summary
This summary is machine-generated.

This study evaluated a treatment algorithm for oxaliplatin-induced peripheral neuropathy in colorectal cancer patients. The algorithm, using pregabalin, duloxetine, and oxycodone, showed a 59% overall response rate, offering a potential management strategy.

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Area of Science:

  • Oncology
  • Neurology
  • Pharmacology

Background:

  • Oxaliplatin (L-OHP) is crucial for colorectal cancer treatment.
  • L-OHP-induced peripheral neuropathy is a dose-limiting side effect, often necessitating treatment withdrawal.
  • Effective management strategies for L-OHP-induced neuropathy are critical for maintaining treatment continuity.

Purpose of the Study:

  • To assess the efficacy and safety of a sequential treatment algorithm for oxaliplatin-induced peripheral neuropathy.
  • To evaluate a three-stage algorithm involving pregabalin, duloxetine, and oxycodone.
  • To determine the overall response rate and side effect profile of the treatment algorithm.

Main Methods:

  • A 4-week prospective study involving 27 colorectal cancer patients with L-OHP-induced peripheral neuropathy.
  • Implementation of a three-stage algorithm: Stage 1 (pregabalin), Stage 2 (duloxetine), Stage 3 (oxycodone).
  • Patients transitioned to the next stage if treatment was ineffective or adverse events occurred; efficacy and side effects were monitored.

Main Results:

  • The overall response rate for the treatment algorithm was 59% (16/27 patients).
  • Stage-specific response rates were 33% for pregabalin, 33% for duloxetine, and 17% for oxycodone.
  • The most frequent side effect reported across all stages was somnolence, with varying side effect rates at each stage (37%, 33%, 83%).

Conclusions:

  • The evaluated treatment algorithm demonstrates potential utility in managing oxaliplatin-induced peripheral neuropathy.
  • Sequential administration of pregabalin, duloxetine, and oxycodone offers a viable therapeutic option.
  • Careful monitoring for side effects, particularly somnolence, is essential during treatment with this algorithm.