Oxaliplatin-induced Peripheral Neuropathy with Hepatic Arterial Versus Intravenous Infusion in Metastatic Colorectal Cancer

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2024 Sep 16

PMID 39283505

Authors

Marine Valery

Marie-Laure Tanguy

Maximiliano Gelli

Cristina Smolenschi

Antoine Hollebecque

Alice Boileve

Elena Fernandez de Sevilla

Lambros Tselikas

Baptiste Bonnet

Diane Goere

Julien Taieb

Valerie Boige

Michel Ducreux

David Malka

Affiliations

Soon will be listed here.

Abstract

Background: Oxaliplatin, a major drug in metastatic colorectal cancer (mCRC), is responsible for cumulative, dose-limiting peripheral neuropathy (PN). Whether the hepatic arterial infusion (HAI) route can limit oxaliplatin-induced PN in comparison with the intravenous (IV) route has not been specifically explored so far.

Methods: We compared the frequency and severity of PN in oxaliplatin-naive patients with mCRC included in trials that evaluated treatment with oxaliplatin administered either by HAI (ACCORD 04, CHOICE, OSCAR, and PACHA-01 trials) or by IV route (FFCD 2000-05 trial). We retrieved anonymized, prospectively collected data from trial databases for the ACCORD 04, CHOICE, and FFCD 2000-05 trials and through a review of Gustave Roussy patients' electronic medical records for PACHA-01 and OSCAR trials. The primary endpoint was the incidence of clinically significant PN (grades 2 to 4) according to the cumulative dose of oxaliplatin received. Secondary endpoints were time to onset of neuropathy as a function of the cumulative dose of oxaliplatin, discontinuation of oxaliplatin for neurotoxicity, and safety.

Results: A total of 363 patients were included (IV, 300; HAI, 63). In total, 180 patients in the IV group (60%) and 30 patients in the HAI group (48%) developed clinically significant PN, with no significant difference between the two groups (p = 0.23). No difference was shown in the time to onset of PN either (p = 0.23).

Conclusion: The administration of oxaliplatin HAI rather than IV in the treatment of mCRC does not reduce the incidence, precocity, and severity of PN.

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