Impact of peripheral neuropathy induced by platinum in first-line chemotherapy on second-line chemotherapy containing paclitaxel for advanced gastric cancer.

Authors

null

Ryo Otsuka

Department of Pharmacy, National Cancer Center Hospital, Tokyo, Tokyo, Japan

Ryo Otsuka , Satoru Iwasa , Takako Yanai , Hirokazu Shoji , Yoshitaka Honma , Natsuko Okita , Atsuo Takashima , Ken Kato , Hironobu Hashimoto , Yoshinori Makino , Masatoshi Sekiguchi , Yoshimasa Ishizone , Narikazu Boku , Masakazu Yamaguchi

Organizations

Department of Pharmacy, National Cancer Center Hospital, Tokyo, Tokyo, Japan, National Cancer Center Hospital, Department of Experimental Therapeutics, Tokyo, Japan, Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan, Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan, Department of Pharmacy, National Cancer Center Hospital, Tokyo, Chuo-Ku, Japan, Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan, Department of Pharmacy, National Cancer Center Hospital,Tokyo, Tokyo, Japan

Research Funding

Other

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of platinum and paclitaxel (PTX) persisting for long time. In the Gastric Cancer Treatment Guideline (Japanese Gastric Cancer Association, 2018), first-line chemotherapy with fluoropyrimidine plus platinum followed by taxane based chemotherapy is recommended. It is not well known how much CIPN by platinum in the first-line chemotherapy affect the tolerability of second-line chemotherapy containing PTX (second-PTX). Methods: The subjects were advanced gastric cancer patients who received second-PTX after the platinum-containing first-line chemotherapy between March 2015 and June 2018. Patients were divided into two groups according to prior platinum: oxaliplatin (prior L-OHP) and cisplatin (prior CDDP) groups. CIPN was graded according to CTCAE ver.4. Severity of CIPN, dose reduction and discontinuation due to CIPN during the second-PTX were compared between the two groups. Results: 109 patients (50 prior L-OHP group and 59 prior CDDP group) were included in this retrospective study. The severity of CIPN just before second-PTX was 46% for grade 1 and 12% for grade 2 in the prior L-OHP group, and 8.5% and 0% in the prior CDDP group. The initial dose of PTX was reduced in 59 % of the prior L-OHP and in 39 % of the prior CDDP group. The worst grade of CIPN during second-PTX was 40% for grade 1, 34% for grade 2, 14% for grade 3 in the prior L-OHP group, and 33.9%, 20.3%, 0% in the prior CDDP group. Median time to grade 2 neuropathy during second-PTX was 2.5 months in the prior L-OHP group and 8.6 months in the prior CDDP group (p = 0.0004). CIPN-related dose reduction of PTX were 12.0% in the prior L-OHP group and 3.4% in the prior CDDP group (p = 0.177). Discontinuation of second-PTX due to CIPN were 10.0% in the prior L-OHP group and 5.1% in the prior CDDP group (p = 0.541). Conclusions: The severity of CIPN and tolerability of the second-PTX may be affected by prior platinum, L-OHP or CDDP, in the first-line chemotherapy for advanced gastric cancer.

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Abstract Details

Meeting

2019 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach

Track

Cancers of the Esophagus and Stomach

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 37, 2019 (suppl 4; abstr 132)

DOI

10.1200/JCO.2019.37.4_suppl.132

Abstract #

132

Poster Bd #

L4

Abstract Disclosures