Irinotecan-induced dysarthria and management

Area of Science:

• Oncology
• Neuropharmacology

Background:

• Irinotecan is a chemotherapy agent used for abdominal cancers.
• Neurotoxicities, including dysarthria, are rare but possible side effects.
• Modified FOLFIRINOX (fluorouracil, irinotecan, oxaliplatin) is a common regimen.

Purpose of the Study:

• To report a case of irinotecan-induced dysarthria in a pancreatic cancer patient.
• To describe a successful management strategy for this rare neurotoxicity.

Main Methods:

• A patient with pancreatic cancer received modified FOLFIRINOX.
• Dysarthria developed, and causality was assessed using Naranjo criteria (score 6).
• Management involved steroids, lorazepam, and later prophylactic atropine with extended infusion times.

Main Results:

• The patient experienced probable irinotecan-induced dysarthria.
• The modified treatment strategy (atropine, longer infusion) effectively alleviated symptoms.
• The patient completed 12 cycles of therapy, achieving a partial response.

Conclusions:

• Prolonging irinotecan infusion time and using prophylactic atropine can prevent rare neurotoxicities.
• This strategy may allow patients to complete chemotherapy and achieve treatment response.