Impact of peripheral neuropathy induced by platinum in first-line chemotherapy on second-line chemotherapy with paclitaxel for advanced gastric cancer

• Published in: International journal of clinical oncology Vol. 25; no. 4; pp. 595 - 601
• Main Authors: Otsuka, Ryo, Iwasa, Satoru, Yanai, Takako, Hirano, Hidekazu, Shoji, Hirokazu, Honma, Yoshitaka, Okita, Natsuko, Takashima, Atsuo, Kato, Ken, Hashimoto, Hironobu, Sekiguchi, Masatoshi, Makino, Yoshinori, Boku, Narikazu, Yamaguchi, Masakazu
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.04.2020; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer Research; Chemotherapy; Cisplatin; Cisplatin - administration & dosage; Female; Gastric cancer; Humans; Immunotherapy; Male; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Oncology; Original Article; Oxaliplatin; Oxaliplatin - administration & dosage; Paclitaxel; Paclitaxel - administration & dosage; Peripheral Nervous System Diseases - chemically induced; Peripheral neuropathy; Platinum; Ramucirumab; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Surgical Oncology; Oxaliplatin; Peripheral neuropathy; Gastric cancer; Cisplatin; Paclitaxel
• ISSN: 1341-9625; 1437-7772; 1437-7772
• DOI: 10.1007/s10147-019-01598-5

Background Fluoropyrimidine plus platinum, followed by paclitaxel (PTX) plus ramucirumab is a recommended treatment strategy for advanced gastric cancer (AGC). We investigated how peripheral neuropathy (PN), induced by platinum in first-line chemotherapy, affected the tolerability of second-line chemotherapy with PTX (2nd-PTX). Methods The subjects were AGC patients who received second-line chemotherapy with PTX (2nd-PTX) after the failure of platinum-based chemotherapy between March 2015 and June 2018. We retrospectively reviewed PN severity, and dose reduction and/or discontinuation due to PN during 2nd-PTX, and compared the cumulative incidence of grade 2 PN between the two groups according to first-line chemotherapy containing oxaliplatin (L-OHP) or cisplatin (CDDP). Results The L-OHP and CDDP groups consisted of 50 patients each. PN severity before 2nd-PTX was grade 1/2 in 46/12% of patients in the L-OHP group, and 100/0% in the CDDP group. The worst grades of chemotherapy-induced PN during 2nd-PTX were grades 1/2/3 in 40/34/14% of patients in the L-OHP group, and 36/18/0% in the CDDP group. Median time to grade 2 PN after starting second-PTX was 2.5 months in the L-OHP group and 8.6 months in the CDDP group (hazard ratio 3.34, p  = 0.002). The frequencies of a PN-related dose reduction and/or discontinuation of PTX were 18% in the L-OHP group and 8% in the CDDP group ( p  = 0.234). Conclusions The severity of PN and tolerability of 2nd-PTX may be affected by first-line chemotherapy with L-OHP or CDDP for AGC.