Abstract 856
Background
Assessment of chemotherapy-induced peripheral neurotoxicity (CIPN) usually depends on subjective grading scales, such as the Common Terminology Criteria for Adverse Events (CTCAE). We previously validated a newly developed point-of-care nerve conduction device (POCD) for the objective and quantitative assessment of CIPN. The present study used this POCD to prospectively track the natural history of paclitaxel (PTX)-related CIPN.
Methods
Sural nerve amplitude potentials (SNAP, μV), a quantitative measure of axonal degeneration, and sural nerve conduction velocity (SNCV, m/s), a quantitative measure of the degree of demyelination, were evaluated using a portable, automated POCD (DPN-Check®, Neurometrix Inc., Waltham, MA, USA) in patients with breast cancer scheduled to receive 12 cycles of adjuvant or neoadjuvant weekly PTX, at baseline, after every 2 cycles of PTX (on the first day of the 3rd, 5th, 7th, 11th cycles), and within 1 month after the 12th cycle of PTX. The severity of CIPN was also evaluated according to the CTCAE, version 4.0.
Results
55 patients completed 12 cycles of PTX (median age 51 years, range 32-74; adjuvant/neoadjuvant = 40/15; worst CTCAE G1/G2/G3 = 32/16/7). A total of 49 patients received dose-dense EC (epirubicin + cyclophosphamide) before PTX, and 18 patients with HER2-positive breast cancer received trastuzumab concurrently with PTX. SNAP decreased significantly during each cycle of chemotherapy (repeated ANOVA, P < 0.001), whereas there was no significant change in SNCV (Table). The total sum of SNAP (mean±SD) was 91.7±30.6 in G1, 70.5±30.0 in G2, and 41.4±13.1 in G3. The total sum of SNCV (mean±SD) was 393.5±34.0 in G1, 381.4±39.5 in G2, and 370.1±45.3 in G3. The total SNAP differed significantly according to each CTCAE grade (ANOVA, P < 0.001), whereas the total SNCV did not.Table:
1801P Longitudinal tracking of SNAP and SNCV among 55 patients (mean±SD)
baseline | 3rd | 5th | 7th | 9th | 11th | 1 month after 12th cycle | |
---|---|---|---|---|---|---|---|
SNAP (μV) | 14.2± 6.3 | 12.2± 4.8 | 11.9± 4.8 | 11.4± 5.7 | 10.7± 5.0 | 9.5± 4.9 | 9.0± 4.8 |
SNCV (m/s) | 56.6± 4.0 | 55.9± 4.9 | 56.2± 4.8 | 56.2± 4.8 | 55.3± 4.4 | 55.4± 4.8 | 55.4± 4.6 |
Conclusions
This POCD demonstrated SNAP-dominant neuropathy in patients who received PTX, suggesting axonal degeneration as a mechanism of CIPN.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
Y. Ando: Honoraria (self): Bristol-Myers Squibb Company; Honoraria (self): Sawai Pharmaceutical Co. Ltd.; Research grant / Funding (self): Mochida Pharmaceutical Co.,Ltd.; Honoraria (self), Research grant / Funding (self): Nippon Kayaku Co.,Ltd.; Honoraria (self), Research grant / Funding (self): Taiho Pharmaceutical Co., Ltd. All other authors have declared no conflicts of interest.
Resources from the same session
5011 - LCSCAF1 maintains cancer stem-like traits by stabilizing c-Myc protein and promotes metastasis and recurrence in lung cancer
Presenter: Tao Guo
Session: Poster Display session 1
Resources:
Abstract
4955 - XAF1 Enhances Temozolomide Induced Autophagic Cell Death through AMPK signaling pathway
Presenter: Mingoo Lee
Session: Poster Display session 1
Resources:
Abstract
5616 - The effect of cortisol on methylation patterns in breast cancer cell lines
Presenter: Haya Intabli
Session: Poster Display session 1
Resources:
Abstract
4649 - Global and sex-specific epigenome-wide association studies for the identification of the main methylated loci related to smoking in a Mediterranean population
Presenter: Judith Begona Ramirez Sabio
Session: Poster Display session 1
Resources:
Abstract
4984 - Whole transcriptomics analyses of mimicking Circulating Tumor Cells (CTCs) by single-cell RNA sequencing (scRNAseq)
Presenter: Jessica Garcia
Session: Poster Display session 1
Resources:
Abstract
5926 - Comparison of enzymatic- and bisulfite conversion to map the plasma cell-free methylome in cancer
Presenter: Nicole Lambert
Session: Poster Display session 1
Resources:
Abstract
5454 - Detection of low mutations in hepatocellular carcinoma by using circulating tumor DNA
Presenter: Esl Kim
Session: Poster Display session 1
Resources:
Abstract
4428 - Variants in the JAK1 and JAK2 genes in the risk and prognosis of patients with cutaneous melanoma
Presenter: Bruna Carvalho
Session: Poster Display session 1
Resources:
Abstract
4409 - P-Rex1 expression in breast cancer patients.
Presenter: Angela Lara Montero
Session: Poster Display session 1
Resources:
Abstract
4185 - Modulation of Risk of Cutaneous Melanoma Patients by Variants in STAT3 Gene and Functional Analysis
Presenter: Gabriela Gomez
Session: Poster Display session 1
Resources:
Abstract