title: Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505).
abstract: Oxaliplatin and paclitaxel are commonly used chemotherapies associated with acute and chronic neuropathies. There is a need to better understand the similarities and differences of these clinical syndromes.
  
  
  
  Neuropathy data were pooled from patients receiving adjuvant oxaliplatin and weekly paclitaxel or every 3 weeks of paclitaxel. Patients completed daily questionnaires after each chemotherapy dose and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire for patients with chemotherapy-induced peripheral neuropathy before each chemotherapy cycle and for 12 months post-treatment.
  
  
  
  Acute neuropathy symptoms from both drugs peaked around day 3. Acute symptoms experienced in cycle 1 predicted occurrence in subsequent cycles. Paclitaxel-induced acute symptoms were similar in intensity in each cycle and largely resolved between cycles. Oxaliplatin-induced acute symptoms were about half as severe in the first cycle as in later cycles and did not resolve completely between cycles. Both drugs caused a predominantly sensory chronic neuropathy (with numbness and tingling being more common than pain). Oxaliplatin-induced neuropathy worsened after the completion of treatment and began to improve 3 months post-treatment. In contrast, paclitaxel-induced neuropathy began improving immediately after chemotherapy cessation. During treatment, the incidence of paclitaxel sensory symptoms was similar in the hands and feet; with oxaliplatin, the hands were affected more than the feet. Both paclitaxel- and oxaliplatin-induced acute neurotoxicity appeared to predict the severity of chronic neuropathy, more prominently with oxaliplatin.
  
  
  
  Knowledge of the similarities and differences between neuropathy syndromes may provide insight into their underlying pathophysiology and inform future research to identify preventative treatment approaches.
authors.affiliation: Department of Oncology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA. pachman.deirdre@mayo.edu.
authors.forename: Deirdre R
authors.initials: DR
authors.lastname: Pachman
authors.affiliation: Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rui
authors.initials: R
authors.lastname: Qin
authors.affiliation: Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA.
authors.forename: Drew
authors.initials: D
authors.lastname: Seisler
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: Ellen M Lavoie
authors.initials: EM
authors.lastname: Smith
authors.affiliation: Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA.
authors.forename: Suneetha
authors.initials: S
authors.lastname: Kaggal
authors.affiliation: Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Novotny
authors.affiliation: Department of Oncology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Ruddy
authors.affiliation: Department of Oncology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Lafky
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Ta
authors.affiliation: Department of Oncology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.
authors.forename: Andreas S
authors.initials: AS
authors.lastname: Beutler
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Nina D
authors.initials: ND
authors.lastname: Wagner-Johnston
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Nathan P
authors.initials: NP
authors.lastname: Staff
authors.affiliation: Department of Oncology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.
authors.forename: Axel
authors.initials: A
authors.lastname: Grothey
authors.affiliation: Department of Pain Medicine, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Dougherty
authors.affiliation: Experimental Neurology Unit and Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Cavaletti
authors.affiliation: Department of Oncology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D000077150:Oxaliplatin; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000188:drug therapy
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D017239:Paclitaxel
keywords: Chemotherapy-induced peripheral neuropathy; Oxaliplatin neuropathy; Paclitaxel neuropathy