Hannah C Timmins1, Tiffany Li1, William Huynh2, Matthew C Kiernan1, Sally Baron-Hay3, Frances Boyle4, David Goldstein5, Susanna B Park6. 1. Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia. 2. Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia; Prince of Wales Clinical School, UNSW, Australia. 3. Department of Oncology, Royal North Shore Hospital, Australia. 4. Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital, Australia. 5. Prince of Wales Clinical School, UNSW, Australia. 6. Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia. Electronic address: susanna.park@sydney.edu.au.
Abstract
OBJECTIVE: To comprehensively describe patient-reported, functional and neurophysiological outcomes to elucidate the phenotypic profile of taxane-induced neuropathy. METHODS: Taxane-treated patients (n = 47) completed cross-sectional bilateral clinical and sensory assessments and nerve conduction studies. Patients reported symptom severity via Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx13) questionnaire. RESULTS: Symptoms of neuropathy were reported by 81% of patients. On clinical examination, 62% had 2 or more abnormalities, with 20% indicating significant symptomatic and objective neuropathy. Nerve conduction studies were consistent with a sensory predominant axonal neuropathy. However, features more typical of entrapment neuropathy were also present in > 50%, which were not associated with overall severity of chemotherapy-induced peripheral neuropathy (CIPN) or clinical risk factors. CONCLUSIONS: There is considerable variation in CIPN phenotypes associated with taxane-treatment. Understanding their clinical associations may assist in identification of patients at risk of severe neurotoxicity. This would enable treatment modification decisions but also limit early cessation of effective anti-cancer treatment in patients with less severe neurological sequelae. SIGNIFICANCE: Understanding the CIPN phenotype may inform treatment decisions which could impact clinical and survival outcomes.
OBJECTIVE: To comprehensively describe patient-reported, functional and neurophysiological outcomes to elucidate the phenotypic profile of taxane-induced neuropathy. METHODS:Taxane-treated patients (n = 47) completed cross-sectional bilateral clinical and sensory assessments and nerve conduction studies. Patients reported symptom severity via Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx13) questionnaire. RESULTS: Symptoms of neuropathy were reported by 81% of patients. On clinical examination, 62% had 2 or more abnormalities, with 20% indicating significant symptomatic and objective neuropathy. Nerve conduction studies were consistent with a sensory predominant axonal neuropathy. However, features more typical of entrapment neuropathy were also present in > 50%, which were not associated with overall severity of chemotherapy-induced peripheral neuropathy (CIPN) or clinical risk factors. CONCLUSIONS: There is considerable variation in CIPN phenotypes associated with taxane-treatment. Understanding their clinical associations may assist in identification of patients at risk of severe neurotoxicity. This would enable treatment modification decisions but also limit early cessation of effective anti-cancer treatment in patients with less severe neurological sequelae. SIGNIFICANCE: Understanding the CIPN phenotype may inform treatment decisions which could impact clinical and survival outcomes.
Authors: Hannah C Timmins; Tiffany Li; Terry Trinh; Matthew C Kiernan; Michelle Harrison; Frances Boyle; Michael Friedlander; David Goldstein; Susanna B Park Journal: Oncologist Date: 2021-02-10
Authors: R Velasco; A A Argyriou; C Marco; S Mariotto; A Stradella; J Hernández; S Pernas; S Ferrari; J Bruna Journal: J Neurol Date: 2022-09-12 Impact factor: 6.682
Authors: Hannah C Timmins; Tiffany Li; David Goldstein; Terry Trinh; David Mizrahi; Michelle Harrison; Lisa G Horvath; Michael Friedlander; Matthew C Kiernan; Susanna B Park Journal: J Cancer Surviv Date: 2021-02-27 Impact factor: 4.442