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Printable Handouts
Navigable Slide Index
- Introduction
- Talk topics
- Incidence/causative agents
- Natural history
- Illustrate with 2 agents
- Oxaliplatin
- Acute neuropathy symptoms
- Sensitivity to touching cold items
- Discomfort swallowing cold liquids
- Throat discomfort
- Muscle cramps
- Oxaliplatin more chronic neuropathy
- Mean percent of baseline: CIPN-20 scores
- Individual questions from the CIPN-20
- CIPN-20 subscale scores
- CIPN-20 single item scores after treatment
- CIPN-20 sensory subscale percent after treatment
- CIPN-20 sensory subscale during treatment
- Paclitaxel
- Paclitaxel-associated pain scores per cycle
- Daily mean pain scores
- Paclitaxel more chronic neuropathy
- EORTC CIPN-20 data (weekly)
- EORTC CIPN-20 symptom scores (hands)
- CIPN-20 scores months after chemotherapy
- CIPN-20 symptom scores (feet)
- Manifestations of established bothersome CIPN
- EROTC CIPN-20 symptom relationship
- Percent of reports on the EORTC CIPN-20 scale
- Increased risks
- Measurement
- National cancer institute: common terminology
- Patient reported outcomes
- Patient reported outcomes: trials
- Additional objective measures
- Prevention
- Prevention and management of CIPN
- Prevention data summary
- Preliminary data
- Treatment
- Treatment agents
- Duloxetine trial
- Duloxetine trial design
- Duloxetine trial results
- Confirmatory duloxetine trial
- Conclusions regarding duloxetine
- Endorsed treatment agents
- Gabapentinoid use in clinical practice
- First report of gabapentin use in CIPN
- Gabapentin trial
- Gabapentin & oxaliplatin-induced neuropathy
- Gabapentin efficiency
- Randomized, placebo-controlled trials
- Efficacy of gabapentin in management of CIPN
- Gabapentin trial design
- Mean pain intensity
- Pregabalin trial
- Pregabalin trial (more data)
- Can pregabalin prevent paclitaxel neuropathy?
- Pregabalin ACCRU pilot trial scheme
- EORTC QLQ: CIPN-20 (sensory subscale)
- Conclusions regarding gabapentinoids
- Treatment agents endorsed: topical BAK
- Trial of a topical treatment for CIPN
- Topical treatment for CIPN: trial design
- BAK EORTC CIPN-20, sensory
- BAK EORTC CIPN-20, motor
- AK trial
- Conclusions regarding BAK
- Endorsed treatment: tricyclic antidepressants
- Tricyclic antidepressants (background)
- Conclusions regarding tricyclic antidepressants
- Other therapies: preliminary data
- Scrambler therapy
- What is scrambler therapy?
- Scrambler therapy results
- How does scrambler therapy work?
- Scrambler pilot trial for CIPN
- Unadjusted CIPN "pain now" scores
- Mayo trial
- Eligibility & treatment
- Initial CIPN patient cohort
- First patients enrolled in study
- Effect of scrambler therapy on CIPN scores
- Patient scores: lower extremities
- Patient scores: upper extremities
- Mean symptom severity
- Patient recommendation of therapy
- There is ‘no proof’ that scrambler works
- Why do ‘I believe that it works’?
- Ongoing randomized clinical trials
- Conclusions
- Conclusions: treatment recommendations
- Thanks for your attention
Topics Covered
- Chemotherapy-induced neuropathy (CIN) causative agents
- The history of CIN
- Measurement methods for CIN
- Prevention options for CIN
- Available CIN treatments and recommendations
Talk Citation
Loprinzi, C. (2024, October 22). Chemotherapy-induced neuropathy: incidence, natural history, measurement, prevention, and treatment [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 22, 2024, from https://doi.org/10.69645/HDNY2588.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Charles Loprinzi has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Chemotherapy-induced neuropathy: incidence, natural history, measurement, prevention, and treatment
A selection of talks on Cancer
Transcript
Please wait while the transcript is being prepared...
0:00
Good day.
This is Charles Loprinzi
from Mayo Clinic in Rochester,
Minnesota.
I'm happy to talk about
Chemotherapy-Induced Neuropathy.
0:09
Talking about the incidence,
natural history, measurement,
prevention and treatment aspects.
I'll start off by talking about
the incidence and causative agents.
0:20
Chemotherapy-induced neuropathy
is a very common problem
for patients
who are receiving chemotherapy.
It's probably the most
bothersome chronic toxicity
that we, as oncologists, see
with chemotherapy.
Paclitaxel and oxaliplatin
are two of the biggest offenders,
they cause a fair amount
of neuropathy each time,
and they're used quite frequently.
So I estimate that this is probably
80% of the neuropathy
that we see in clinical oncology.
Probably equal
between the two different drugs.
There are other drugs
that can cause
chemotherapy-induced neuropathy.
Other platinum agents
such a cisplatin or carboplatin.
Other taxanes such as docetaxel.
And then there are a variety
of other drugs
and I've listed some there,
that you could see.
These drugs are used less often
than the above noted drugs.
1:06
Let me move now
to the natural history
of chemotherapy-induced neuropathy.
1:12
I'm gonna illustrate this
with two different drugs,
paclitaxel and oxaliplatin.
Both of them have an acute
and a more chronic form
of neuropathy.
1:22
Let me go with oxaliplatin first
and let me talk about
oxaliplatin acute neuropathy.
1:29
This slide illustrates
the acute neuropathy
that's seen with oxaliplatin
by asking patients,
on the day of receiving
their chemotherapy
and for five days there afterwards,
the amount of troubles they have
with sensitivity
to touching cold items,
the most prominent problem,
discomfort swallowing cold items,
throat discomfort,
and muscle cramps,
the least prominent problem.
And as you can see in this slide,
you should see troubles in the very
first cycle of chemotherapy.
And you see twice as much problem
in cycle two compared to cycle one.
And similar amounts of problem
in cycles three through twelve.
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