The Incidence of acute Neurotoxicity among some Iraqi colorectal cancer patients treated with oxaliplatin-based chemotherapy

Rehab AM. Jawad; Bahir Abdul-Razzaq Mshimesh; Qasim S. Al-Mayah; Fawaz Al-Alloosh

doi:10.32947/ajps.v25i3.1223

Authors

Rehab AM. Jawad Department of Pharmacology and Toxicology/ College of Pharmacy/ Mustansiriyah University Baghdad, Iraq
Bahir Abdul-Razzaq Mshimesh Department of Pharmacology and Toxicology/ College of Pharmacy/ Mustansiriyah University Baghdad, Iraq
Qasim S. Al-Mayah Medical Research Unit, College of Medicine, Al-Nahrain University, Iraq
Fawaz Al-Alloosh Medical Oncology department, Warith International Cancer Institute, Iraq

DOI:

https://doi.org/10.32947/ajps.v25i3.1223

Keywords:

Colorectal cancer, Oxaliplatin, neurotoxicity, risk factors

Abstract

Oxaliplatin serves as the primary treatment option for colorectal cancer (CRC) at all stages. It induces acute cold-triggered neurotoxicity and chronic cumulative neurotoxicity, leading to potential dose adjustments and influencing patient quality of life (QOL). However, conventional strategies are lacking for effectively managing oxaliplatin-induced neurotoxicity (OIN).

This observational study is a prospective aimed at investigating the incidence and associated factors of OIN involving 120 patients with CRC at different stages under oxaliplatin-based chemotherapy. The demographic and clinical characteristics of the patients were collected using a preformed data information sheet. The frequency and associated factors were evaluated after the third cycle of the Oxaliplatin chemotherapy. Unfortunately, 84 patients (70%) developed neurotoxicity while 30% did not experience this side effect. None of the included demographic or clinical characteristics were significantly associated with the OIN. Thus, it did not appear to predict neurotoxicity risk in the studied population. Other factors such as genetics could have such an impact and need to be investigated.

References

1- Maksimova PE, Golubinskaya EP, Seferov BD, Zyablitskaya EY. Colorectal cancer: epidemiology, carcinogenesis, molecular subtypes and cellular mechanisms of therapy resistance (analytical review). 2023 21;22(2):160–71.

2- Taha HT Al-Saigh, Shatha A Abdulmawjood, Faris A Ahmed. Prognostic factor of serum carcinoembryonic antigen in colorectal cancer patients: a follow up study. Al Mustansiriyah J Pharm Sci. 2022;21(3):1–6.

3- Klimeck L, Heisser T, Hoffmeister M, Brenner H. Colorectal cancer: A health and economic problem. Best Pract Res Clin Gastroenterol [Internet]. 2023;66:101839.

4- Mauri G, Pedrani M, Ghezzi S, Bencardino K, Mariano S, Bonazzina E, et al. Young-onset colorectal cancer: treatment-related nausea, vomiting and diarrhoea. BMJ Support Palliat Care [Internet]. 2023;13(e3):e885–9.

5- Ibrahem S, Ahmed H, Zangana S. Trends in colorectal cancer in Iraq over two decades: incidence, mortality, topography and morphology.. 2022;42(4):252–61.

6- Zhou Q nan, Lei R e, Liang Y xiao, Li S qi, Guo X wen, Hu B li. Oxaliplatin-related lncRNAs prognostic models predict the prognosis of patients given oxaliplatin-based chemotherapy. Cancer Cell Int. 2023 27;23(1):103.

7- Rashid MA, Tang JJ, Yoo KH, Corujo-Ramirez A, Kim SH, Oliveros A, et al. Abstract 2694: Blockade of the cyclooxygenase-2 prevents chemotherapy-induced cognitive impairments. 2023 4;83(7_Supplement):2694–2694.

8- Assenat E, BEN Abdelghani M, Monnier M, Perrier H, Khemissa F, Desgrippes R, et al. LEANOX: Lean body mass normalization of oxaliplatin-based chemotherapy for patients with stage III colon cancer treated in adjuvant setting: Impact on oxaliplatin-induced sensitive neurotoxicity—A multicenter phase II randomized trial. J Clin Oncol [Internet]. 2023 1;41(4_suppl):92–92.

9- Li T, Mizrahi D, Goldstein D, Kiernan MC, Park SB. Chemotherapy and peripheral neuropathy. Neurol Sci [Internet]. 2021 26;42(10):4109–21.

10- Page A, Saindane D, Bhattacharya S, editors. Radiotherapy in Colorectal Cancer. In: Colorectal Cancer Diagnosis and Therapeutic Updates. BENTHAM SCIENCE PUBLISHERS; 2022. p. 81–9.

11- Iimura Y, Furukawa N, Kuroda S. Delayed Oxaliplatin-Related Severe Neurotoxicity in Metastatic Colorectal Cancer: A Case Report. Cureus. 2023 10;

12- Lagampan C, Teeyapan N, Poovorawan N, Sitthideatphaiboon P, Parinyanitikul N, Vinayanuwattikun C, et al. An open-label, randomized, controlled trial to evaluate the efficacy of antihistamine premedication and infusion prolongation in the prevention of hypersensitivity reaction to oxaliplatin. J Clin Oncol. 2022 1;40(16_suppl):12099–12099.

13- Deschamps F, Tselikas L, Tasaki M, Motoyama S, Isoardo T, Ducreux M, et al. Sustained-hepatic arterial infusion of oxaliplatin: pharmacokinetic advantages over hepatic arterial infusion using a preclinical animal tumor model. Drug Deliv Transl Res. 2021 11;11(5):2144–50.

14- Okamoto T, Takagi K, Fukuda K. Oxaliplatin-Induced Lhermitte’s Sign in Gastric Cancer. Case Rep Oncol Med. 2020 24;2020:1–5.

15- Chubykina SV, Tatarinova MU, Avakyan GG. Neuropathic pain caused by the toxic effect of chemotherapy in patients with malignant neoplasms. Zhurnal Nevrol i psychiatric SS Korsakova. 2023;123(5):7.

16- Khan KS, Andersen H. Motor Neuropathy in Diabetes. In 2023. p. 183–201.

17- Kanbayashi Y, Ishikawa T, Kuriu Y, Otsuji E, Takayama K. Predictors for development of oxaliplatin-induced peripheral neuropathy in cancer patients as determined by ordered logistic regression analysis. Wheate NJ, editor. PLoS One. 2022 29;17(9):e0275481.

18- Lee S, Ma C, Shi Q, Kumar P, Couture F, Kuebler P, 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. 2023 10;41(5):1079–91.

19- Teng C, Vardy JL. “POLAR-izing” Findings From Trials of Neuroprotection for Oxaliplatin Neuropathy. JNCI Cancer Spectr. 2022 1;6(6).

20- Bell D, Di Muzio B. ECOG performance status. In: Radiopaedia.org [Internet]. Radiopaedia.org; 2013.

21- Vargas A, Contreras MJ, De la Haba M, Cano MT, Morales-Estevez C, Porras I, et al. Obesity and toxic habits as avoidable determinants of chronic peripheral neuropathy induced by chemotherapy (NPCIQ): NeuroPredict project. J Clin Oncol. 2023 Jun 1;41(16_suppl):e24097–e24097.

22- Timmins HC, Li T, Goldstein D, Trinh T, Mizrahi D, Harrison M, et al. The impact of obesity on neuropathy outcomes for paclitaxel- and oxaliplatin-treated cancer survivors. J Cancer Surviv. 2022 Apr 27;16(2):223–32.

23- Luo D, Li X, Tang S, Song F, Li W, Xie G, et al. Epigenetic modifications in neuropathic pain. Mol Pain. 2021 Jan 26;17:174480692110567.

24- Levin ED. Neurotoxicology of nicotine and tobacco. In 2022. p. 93–103.

25- Ghosh K, Pan HL. Epigenetic Mechanisms of Neural Plasticity in Chronic Neuropathic Pain. ACS Chem Neurosci. 2022 16;13(4):432–41.

26- Ross DM. Peripheral neuropathy on imatinib treatment for chronic myeloid leukaemia: suspected adverse drug interaction with amlodipine. Intern Med J. 2009 14;39(10):708–708.

27- Hines RB, Schoborg C, Sumner T, Zhu X, Elgin EA, Zhang S. The association between sociodemographic, clinical, and potentially preventive therapies with oxaliplatin-induced peripheral neuropathy in colorectal cancer patients. Support Care Cancer. 2023 9;31(7):386.

28- Gündoğdu UD, Karabağ F, Tuğrul F. The Clinical Effect of Triglyceride Glucose Index, an Insulin Resistance Marker, in Predicting Neuropathy Induced by the FOLFOX Chemotherapy Protocol. J Adv Med Med Res. 2022 10;28–32.

29- Yaqeen Talib Mohammed, Nadia Hameed Mohammed, Inam Sameh Arif. The Potential Effect of Simvastatin on Regulatory T cells in Experimentally Induced Autoimmune Thyroiditis in Female Rats. Al Mustansiriyah J Pharm Sci. 2023;23(4):443–53.

30- Tsubaki M, Takeda T, Matsuda T, Kishimoto K, Takefuji H, Taniwaki Y, et al. Statins enhances antitumor effect of oxaliplatin in KRAS-mutated colorectal cancer cells and inhibits oxaliplatin-induced neuropathy. Cancer Cell Int. 2023 17;23(1):73.

31- Sue-Chue-Lam C, Brezden C, Sutradhar R, Yu AY, Baxter NN. Adjuvant oxaliplatin and fall-related injury in patients with colorectal cancer. J Clin Oncol. 2022 1;40(4_suppl):78–78.

32- Otsu S, Hirashima Y, Nishikawa K, Sakashita H, Morinaga R, Watanabe K, et al. Neurological Toxicity in Metastatic Colorectal Cancer Patients Treated with Modified FOLFOX6 plus Bevacizumab. Japanese Clin Med. 2014 12;5:JCM.S15553.

33- Eryılmaz MK, Mutlu H, Salim DK, Musri FY, Coşkun HŞ. Fatal posterior revesible leukoencephalopathy syndrome associated coma induced by bevacizumab in metastatic colorectal cancer and review of literature. J Oncol Pharm Pract. 2016 9;22(6):806–10.