Paola Alberti1,2,3, Emanuela Rossi4, Andreas A Argyriou5,6, Haralabos P Kalofonos6, Chiara Briani7, Mario Cacciavillani8, Marta Campagnolo7, Jordi Bruna9, Roser Velasco9, Marina E Cazzaniga10, Diego Cortinovis10, Maria G Valsecchi4, Guido Cavaletti11,12. 1. Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, U8 Building, 1st Floor, Room 1.10, Via Cadore, 48, 20900, Monza, MB, Italy. p.alberti2@campus.unimib.it. 2. NeuroMI, Milan Center for Neuroscience, Milan, Italy. p.alberti2@campus.unimib.it. 3. PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. p.alberti2@campus.unimib.it. 4. Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. 5. Department of Neurology, Saint Andrew's State General Hospital of Patras, Patras, Greece. 6. Department of Medicine, Division of Oncology, Medical School, University of Patras, Patras, Greece. 7. Department of Neurosciences, University of Padova, Padua, Italy. 8. CEMES-EMG Lab, Data Medica Group, Padua, Italy. 9. Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-ICO L'Hospitalet-IDIBELL, Barcelona, Spain. 10. SC Oncologia Medica, ASST Monza, H S Gerardo, Monza, Italy. 11. Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, U8 Building, 1st Floor, Room 1.10, Via Cadore, 48, 20900, Monza, MB, Italy. 12. NeuroMI, Milan Center for Neuroscience, Milan, Italy.
Abstract
PURPOSE: We aimed to verify the predictiveness of dorsal sural nerve neurophysiological monitoring in obtaining risk stratification for oxaliplatin-induced peripheral neurotoxicity (OXAPN). METHODS: We conducted a secondary analysis on a cohort of 110 colorectal cancer patients who were evaluated clinically and neurophysiologically before chemotherapy, at mid-treatment and at discontinuation. We applied the classification tree analysis method to predict the end-of-treatment OXAPN neurophysiological diagnosis, using data recorded at mid-treatment. We then ascertained the correlation between the obtained classes and neurological impairment at the end of treatment (Fisher's exact test). RESULTS: Dorsal sural nerve monitoring enabled us to stratify oxaliplatin-treated patients into risk classes with an implemented approach to neurophysiology application in this setting. Neurological outcome at discontinuation was predicted by neurophysiological monitoring performed during chemotherapy administration. CONCLUSIONS: We demonstrated the role that neurophysiology may play in clinical trials as an early surrogate marker that can predict OXAPN development at the end of treatment. Specifically, we propose abnormal dorsal sural sensory nerve testing as an early biomarker in identifying patients at high risk of eventually developing OXAPN.
PURPOSE: We aimed to verify the predictiveness of dorsal sural nerve neurophysiological monitoring in obtaining risk stratification for oxaliplatin-induced peripheral neurotoxicity (OXAPN). METHODS: We conducted a secondary analysis on a cohort of 110 colorectal cancerpatients who were evaluated clinically and neurophysiologically before chemotherapy, at mid-treatment and at discontinuation. We applied the classification tree analysis method to predict the end-of-treatment OXAPN neurophysiological diagnosis, using data recorded at mid-treatment. We then ascertained the correlation between the obtained classes and neurological impairment at the end of treatment (Fisher's exact test). RESULTS: Dorsal sural nerve monitoring enabled us to stratify oxaliplatin-treated patients into risk classes with an implemented approach to neurophysiology application in this setting. Neurological outcome at discontinuation was predicted by neurophysiological monitoring performed during chemotherapy administration. CONCLUSIONS: We demonstrated the role that neurophysiology may play in clinical trials as an early surrogate marker that can predict OXAPN development at the end of treatment. Specifically, we propose abnormal dorsal sural sensory nerve testing as an early biomarker in identifying patients at high risk of eventually developing OXAPN.
Authors: Jennifer S Gewandter; Roy Freeman; Rachel A Kitt; Guido Cavaletti; Lynn R Gauthier; Michael P McDermott; Nimish A Mohile; Supriya G Mohlie; A Gordon Smith; Mohamedtaki A Tejani; Dennis C Turk; Robert H Dworkin Journal: Neurology Date: 2017-07-26 Impact factor: 9.910
Authors: Christina Teng; Jordan Cohen; Sam Egger; Prunella L Blinman; Janette L Vardy Journal: Support Care Cancer Date: 2021-08-19 Impact factor: 3.603