Ting Bao1, Andrew D Seidman2, Lauren Piulson3, Emily Vertosick4, Xi Chen5, Andrew J Vickers6, Victoria S Blinder7, Wanqing I Zhi8, Qing Li9, Linda T Vahdat10, Maura N Dickler11, Mark E Robson12, Jun J Mao13. 1. Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA. Electronic address: baot@mskcc.org. 2. Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA. Electronic address: seidmana@mskcc.org. 3. Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA. Electronic address: piulsonl@mskcc.org. 4. Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY, 10017, USA. Electronic address: vertosie@mskcc.org. 5. Memorial Sloan Kettering Cancer Center, 444 E 68th Street, New York, NY, 10065, USA. Electronic address: chenx2@mskcc.org. 6. Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY, 10017, USA. Electronic address: vickersa@mskcc.org. 7. Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, New York, NY, 10017, USA. Electronic address: blinderv@mskcc.org. 8. Memorial Sloan Kettering Cancer Center Commack, 650 Commack Road, Commack, NY, 11725, USA. Electronic address: zhiw@mskcc.org. 9. Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA. Electronic address: liq2@mskcc.org. 10. Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA. Electronic address: vahdatl@mskcc.org. 11. Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA. Electronic address: dicklerm@mskcc.org. 12. Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA. Electronic address: robsonm@mskcc.org. 13. Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA. Electronic address: maoj@mskcc.org.
Abstract
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially dose-limiting side-effect of neurotoxic chemotherapy for cancer patients. We evaluated the preliminary efficacy of acupuncture in preventing worsening CIPN in patients receiving paclitaxel. METHODS: In this phase IIA single-arm clinical trial, we screened stage I-III breast cancer patients receiving neoadjuvant/adjuvant weekly paclitaxel for development of CIPN. The primary objective was to assess acupuncture's efficacy in preventing the escalation of National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE), version 4.0, grade II CIPN to higher grades. Acupuncture was deemed worthy of further study if 23 or more of the 27 enrolled patients did not develop grade III CIPN. Outcome measures (NCI-CTCAE CIPN grade, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity [FACT/GOG-Ntx], Neuropathic Pain Scale [NPS]) were obtained weekly during the intervention. RESULTS: Of 104 patients screened, 37 developed grade II CIPN (36%), and 28 (27%) enrolled into the intervention phase; one was removed due to protocol violation. Of the 27 patients receiving acupuncture, 26 completed paclitaxel treatment without developing grade III CIPN, meeting our prespecified success criteria for declaring acupuncture worthy of further study. FACT/GOG-Ntx and NPS scores remained stable during the intervention while continuing weekly paclitaxel. Acupuncture treatment was well tolerated; 4 of 27 (15%) patients reported grade I bruising. CONCLUSIONS: Acupuncture was safe and showed preliminary evidence of effectiveness in reducing the incidence of high grade CIPN during chemotherapy. A follow-up randomised controlled trial is needed to establish definitive efficacy in CIPN prevention for patients at risk.
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially dose-limiting side-effect of neurotoxic chemotherapy for cancerpatients. We evaluated the preliminary efficacy of acupuncture in preventing worsening CIPN in patients receiving paclitaxel. METHODS: In this phase IIA single-arm clinical trial, we screened stage I-III breast cancerpatients receiving neoadjuvant/adjuvant weekly paclitaxel for development of CIPN. The primary objective was to assess acupuncture's efficacy in preventing the escalation of National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE), version 4.0, grade II CIPN to higher grades. Acupuncture was deemed worthy of further study if 23 or more of the 27 enrolled patients did not develop grade III CIPN. Outcome measures (NCI-CTCAE CIPN grade, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity [FACT/GOG-Ntx], Neuropathic Pain Scale [NPS]) were obtained weekly during the intervention. RESULTS: Of 104 patients screened, 37 developed grade II CIPN (36%), and 28 (27%) enrolled into the intervention phase; one was removed due to protocol violation. Of the 27 patients receiving acupuncture, 26 completed paclitaxel treatment without developing grade III CIPN, meeting our prespecified success criteria for declaring acupuncture worthy of further study. FACT/GOG-Ntx and NPS scores remained stable during the intervention while continuing weekly paclitaxel. Acupuncture treatment was well tolerated; 4 of 27 (15%) patients reported grade I bruising. CONCLUSIONS: Acupuncture was safe and showed preliminary evidence of effectiveness in reducing the incidence of high grade CIPN during chemotherapy. A follow-up randomised controlled trial is needed to establish definitive efficacy in CIPN prevention for patients at risk.
Authors: Mareye Voortman; Daan Fritz; Oscar J M Vogels; Filip Eftimov; Diederik van de Beek; Matthijs C Brouwer; Marjolein Drent Journal: Curr Opin Pulm Med Date: 2017-09 Impact factor: 3.155
Authors: Weidong Lu; Anita Giobbie-Hurder; Rachel A Freedman; Im Hee Shin; Nancy U Lin; Ann H Partridge; David S Rosenthal; Jennifer A Ligibel Journal: Oncologist Date: 2019-10-14
Authors: Weidong Lu; Anita Giobbie-Hurder; Rachel A Freedman; Im Hee Shin; Nancy U Lin; Ann H Partridge; David S Rosenthal; Jennifer A Ligibel Journal: Oncologist Date: 2019-10-14