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Oxaliplatin is a third-generation platinum anticancer drug, which has a good effect on colorectal cancer and ovarian cancer, and has a certain effect
on gastric cancer, non-Hodgkin lymphoma, non-small cell lung cancer, and head and neck tumors.
Peripheral neurotoxicity is a common adverse effect
of oxaliplatin.
The objective of the CALGB/SWOG 80702 study was to evaluate the association of length of treatment, celecoxib use, physical activity, body mass index (BMI), diabetes, and vitamin B6 with oxaliplatin-induced peripheral neuropathy (OPIN) in patients with stage III colon cancer
.
This was a prospective, observational study in which 2450 patients with stage III colon cancer were randomized into two groups to receive 6 or 12 courses of adjuvant chemotherapy with fluorouracil, folic acid, and oxaliplatin for 3 years ± celecoxib
.
After 15 to 17 months of randomization, the incidence
of OPIN in both groups was assessed.
Patients treated with 12 courses were significantly more likely to develop higher-grade neuropathy and take longer to recover compared with the 6-course group, whereas neither celecoxib nor vitamin B6 intake attenuated OIPN
.
Exercise ≥ 9 MET hours per week after treatment compared with 9 MET hours of exercise < improved OPIN (adjusted mean difference: 1.
47, p=0.
003).
Patients with a BMI≥25 had a significantly higher risk of developing advanced OPIN during oxaliplatin therapy compared with those with a baseline BMI <25 (adjusted odds ratio: 1.
18, p=0.
05).
People with diabetes were more likely to develop more severe neuropathy than those without diabetes (adjusted mean difference: -2.
0, p=0.
002).
Finally, there was no significant interaction
between the duration of oxaliplatin treatment and these potentially modifiable exposures.
In summary, lower physical activity, higher BMI, diabetes, and longer duration of planned treatment may be associated with a significant increase in the severity of oxaliplatin-induced peripheral neuropathy; Celecoxib use and vitamin B6 intake were not significantly associated
with oxaliplatin-induced peripheral neuropathy.
Original source:
Seohyuk Lee, et al.
Potential Mediators of Oxaliplatin-Induced Peripheral Neuropathy From Adjuvant Therapy in Stage III Colon Cancer: Findings From CALGB (Alliance)/SWOG 80702.
J Clin Oncol.
November, 2022.
https://ascopubs.
org/doi/abs/10.
1200/JCO.
22.
01637?role=tab
