Oxaliplatin and axonal Na+ channel function in vivo.
OBJECTIVE
The aim of the study was to investigate the pathophysiology of oxaliplatin-induced neurotoxicity using clinical nerve excitability techniques that provide information about axonal ion channel function.


METHODS
Excitability studies were combined with standard nerve conduction studies and clinical assessment in 22 patients undergoing treatment with oxaliplatin.


RESULTS
Excitability studies recorded before and immediately after oxaliplatin infusion for 89 treatment cycles revealed significant increases in refractoriness and relative refractory period postinfusion in all patients, consistent with an effect of oxaliplatin on axonal Na(+) channels. However, those patients that developed chronic neuropathy had significantly greater changes. Following cessation of oxaliplatin treatment, 41% of patients had persistent symptoms and nerve conduction abnormalities consistent with the development of chronic neuropathy.


CONCLUSIONS
The present study provides evidence that oxaliplatin-induced neurotoxicity is mediated through an effect on axonal Na(+) channels. Clinical nerve excitability techniques may prove beneficial in monitoring for early signs of neurotoxicity and in the assessment of future prophylactic therapies.
Krishnan
Arun V
AV
Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Goldstein
David
D
Friedlander
Michael
M
Kiernan
Matthew C
MC
D000328:Adult; D001369:Axons / Q000187:drug effects* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000503:physiopathology; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D011446:Prospective Studies; D015222:Sodium Channels / Q000187:drug effects*; D016896:Treatment Outcome
D009944:Organoplatinum Compounds; D015222:Sodium Channels; D000077150:Oxaliplatin