Prevention of oxaliplatin-induced peripheral sensory neuropathy by carbamazepine in patients with advanced colorectal cancer.
Oxaliplatin plays a key role in the treatment of advanced colorectal cancer. The dose-limiting side effect of this platinum analogue is neurotoxicity. Significant efforts have been undertaken in an attempt to prevent and/or circumvent the development of neurotoxicity. Sodium channel inactivation kinetics on rat sensory sural nerve preparations are altered after exposure to oxaliplatin. Carbamazepine antagonizes this effect in vitro. Results from preliminary clinical studies indicate that the sodium channel blockers carbamazepine and gabapentin may be effective in preventing neurotoxicity. The role of amifostine is not yet clear. Randomized clinical studies are necessary to confirm the potential benefit of carbamazepine and other sodium channel blockers in preventing and/or overcoming the development of oxaliplatin-induced neurotoxicity.
Lersch
Christian
C
II. Medical Hospital and Health Center, Technischen Universität München, Klinikum rechts der Isar, Ismaninger St 22, 81675 Munich, Germany. christian.lersch@lrz.tum.de
Schmelz
Renate
R
Eckel
Florian
F
Erdmann
Johannes
J
Mayr
Martina
M
Schulte-Frohlinde
Ewert
E
Quasthoff
Stefan
S
Grosskreutz
Julian
J
Adelsberger
Helmuth
H
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D006801:Humans; D066298:In Vitro Techniques; D020258:Neurotoxicity Syndromes / Q000517:prevention & control*; D009944:Organoplatinum Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D000077150:Oxaliplatin; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000517:prevention & control*; D051381:Rats; D026941:Sodium Channel Blockers / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D026941:Sodium Channel Blockers; D000077150:Oxaliplatin; D002220:Carbamazepine