Quantitative Sensory Testing at Baseline and During Cycle 1 Oxaliplatin Infusion Detects Subclinical Peripheral Neuropathy and Predicts Clinically Overt Chronic Neuropathy in Gastrointestinal Malignancies. Reddy SM1, Vergo MT2, Paice JA, et.al.; Clin Colorectal Cancer. 2015 Jul 26
Submitted by Carlos A. Luciano, MD, News Science Editorial Board
Peripheral neuropathy is one of the principal dose- limiting side effects associated with the use of chemotherapy for Cancer treatment. Oxaliplatin, a platinum-based compound used the in the treatment of various solid tumors, is associated with an acute, reversible neurotoxicity in 65% to 98% of patients and with a chronic irreversible sensory axonal neuropathy in up to 46% of patients exposed the medication. The neuropathy is associated with high morbidity and decreased quality of life and thus strategies to limit or prevent this complication are of great importance. In a prospective study in a group of 30 patients with gastrointestinal malignancies undergoing treatment with oxaliplatin, Reddy et.al, applied a battery of tests including measurements of thermal detection and cutaneous sensation and dexterity, prior to and during 4 infusion cycles and at 1 year after infusion (chronic neuropathy). They found that among the various tests performed; Thermal detection thresholds, cutaneous detection thresholds and pellet retrieval time (dexterity) were able to predict the development of chronic neuropathy at 1 year. They were also able to show that thermal (heat detection) thresholds and dexterity measures at baseline were able to predict the development of neuropathy at 1 year, possibly detecting the presence of pre-existing subclinical neuropathy.
COMMENT: This study emphasizes the importance of detection of subclinical neuropathy prior to the exposure to neurotoxic drugs and specifically oxaliplatin for the treatment of gastrointestinal malignancies. This could allow for the use of preventive therapies or adjustments in treatment in patients deemed at high risk for the development of complications. The study also provides important information about the value of comprehensive quantitative sensory testing that incorporates thermal threshold detection measures in the evaluation and prediction of severity of neuropathy in patients receiving or about to receive treatment with oxaliplatin.
About the News Science Editorial Board
The board helps to highlight significant, timely science news items for AANEM members. It reviews articles in journals and websites, identifies newsworthy items in the field, and writes article summaries.