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Paclitaxel-induced neuropathy

T J Postma1, J B Vermorken, A J Liefting

  • 1Department of Neurology, Free University Hospital, Amsterdam, The Netherlands.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|May 1, 1995
PubMed
Summary

Paclitaxel-induced neuropathy is a dose-dependent side effect of cancer treatment. Higher doses increase the risk and severity of neurotoxicity, which is often reversible after treatment cessation.

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Area of Science:

  • Oncology
  • Neuroscience
  • Pharmacology

Background:

  • Paclitaxel (Taxol), derived from Taxus brevifolia, is an antineoplastic agent effective against various cancers.
  • Paclitaxel promotes microtubule assembly, leading to neuropathy as a significant toxic side effect.
  • Understanding paclitaxel-induced neuropathy's incidence, severity, dose-dependency, and reversibility is crucial for patient management.

Purpose of the Study:

  • To prospectively evaluate the incidence, severity, dose-dependency, and reversibility of neuropathy induced by paclitaxel.
  • To assess neurological outcomes in patients receiving single-agent paclitaxel at different dose levels.

Main Methods:

  • Prospective study of 27 patients treated with single-agent paclitaxel at 135, 175, or 250-300 mg/m2 every three weeks.

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  • Neurological evaluations, including standardized questionnaires and examinations, were performed before, during, and after paclitaxel therapy.
  • Quantitative measures like vibratory perception threshold and grip strength were assessed to determine neuropathy severity.

    • Main Results:

    • Neuropathic symptoms and signs increased with higher paclitaxel doses, affecting 50-100% of patients.
    • Dose-limiting neurotoxicity was observed in 0%, 21%, and 71% of patients at the respective dose levels.
    • Paclitaxel-induced neuropathy was primarily sensory, with some motor involvement, and showed partial reversibility upon treatment discontinuation.

    Conclusions:

    • Paclitaxel-induced neuropathy is dose-dependent, correlating with cumulative and per-cycle doses.
    • Neurotoxicity is expected in patients receiving 250 mg/m2 or more per cycle with standard infusion protocols.
    • The findings emphasize the need for careful dose monitoring to mitigate neurotoxic effects in cancer patients treated with paclitaxel.