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Zhu C, Zhang M, Gong S, Du J, Ma L, Liu Y, Li Y, Yu J, Liu N. Identification of Matrine as a Kirsten rats Arcomaviral oncogene homolog inhibitor alleviating chemotherapy-induced neuropathic pain. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 132:155841. [PMID: 38971025 DOI: 10.1016/j.phymed.2024.155841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) represents a prevailing and severe clinical concern, characterized by limited availability of clinically effective treatment strategies. Current evidence endorses matrine's potential as a neuroprotective and analgesic agent for CIPN. Nevertheless, the precise targets and mechanisms of action of matrine remain insufficiently explored, impeding comprehensive pharmacological investigation and clinical application. OBJECTIVE This study endeavors to elucidate the analgesic and neuroprotective effects of matrine in mice with vincristine-induced neuropathic pain. A focal point is the identification of matrine's specific target and the underlying molecular mechanisms governing its analgesic and neuroprotective actions. METHODS To discern matrine's analgesic effects in CIPN mice, we conducted behavioral experiments encompassing the Von Frey filament test and Hargreaves Test. Furthermore, we conducted electrophysiological and histopathological assessments involving HE staining, Nissl staining, and Fluoro-Jade B staining to evaluate matrine's effects on neuroprotection within dorsal root ganglia and the spinal cord of CIPN mice. Sequentially, thermal shift assay, GTP hydrolysis assay, and nucleotide exchange assay were executed to validate matrine's inhibitory effects on KRAS. Molecular docking and site-directed mutagenesis experiments were implemented to identify the precise binding pocket of matrine on KRAS. Lastly, matrine's inhibitory effects on downstream signaling pathways of KRAS were confirmed through experiments conducted at animal model. RESULTS Matrine exhibited a notable increase in mechanical withdrawal threshold and thermal withdrawal latency in vincristine-treated mice. This compound substantially ameliorated the neurofunctional blockade associated with sensory and motor functions induced by vincristine. Moreover, matrine mitigated pathological damage within DRG and the L4-L5 spinal cord regions. The study's MST experiments indicated matrine's substantial elevation of KRAS's melting temperature. The GTP hydrolysis and nucleotide exchange assays revealed concentration-dependent inhibition of KRAS activity by matrine. Molecular docking provided insight into the binding mode of matrine with KRAS, while site-directed mutagenesis verified the specific binding site of matrine on KRAS. Lastly, matrine's inhibition of downstream Raf/Erk1/2 and PI3K/Akt/mTOR signaling pathways of KRAS was confirmed in VCR mice. CONCLUSION Compared to previous studies, our research has identified matrine as a natural inhibitor of the elusive protein KRAS, often considered "undruggable." Furthermore, this study has revealed that matrine exerts its therapeutic effects on chemotherapy-induced peripheral neuropathy (CIPN) by inhibiting KRAS activation, subsequently suppressing downstream signaling pathways such as Raf/Erk1/2 and PI3K/Akt/mTOR. This investigation signifies the discovery of a novel target for matrine, thus expanding the potential scope of its involvement in KRAS-related biological functions and diseases. These findings hold the promise of providing a crucial experimental foundation for forthcoming drug development initiatives centered around matrine, thereby advancing the field of pharmaceutical research.
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Affiliation(s)
- Chunhao Zhu
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China; Medicinal Chemistry and Bioinformatics Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China
| | - Mengting Zhang
- People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750004, PR China
| | - Shuaishuai Gong
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing 210009, PR China
| | - Juan Du
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China
| | - Lin Ma
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China
| | - Yue Liu
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China
| | - Yuxiang Li
- School of nursing, Ningxia Medical University, Yinchuan 750004, Ningxia, PR China
| | - Jianqiang Yu
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China; Ningxia Key Laboratory of Drug Development and Generic Drug Research, Ningxia Medical University, Yinchuan 750004, PR China.
| | - Ning Liu
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China; Ningxia Key Laboratory of Drug Development and Generic Drug Research, Ningxia Medical University, Yinchuan 750004, PR China.
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Dasdemir Ilkhan G, Celikhisar H. Evaluation of chemotherapy-related peripheral neuropathy in lung cancer treatment. TUMORI JOURNAL 2021; 107:392-399. [PMID: 34669524 DOI: 10.1177/0300891620975868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Chemotherapy-related peripheral neuropathies are observed frequently in lung cancer treatment in clinical practice. The present study aimed to evaluate the electrophysiologic findings and clinical symptoms in patients treated for lung cancer with different chemotherapy regimens who had the findings of peripheral neuropathy. METHODS Patients who had electromyography (EMG) examinations with the prediagnosis of peripheral neuropathy at two different centers between January 2011 and December 2019 were included. The demographic data, neurologic examination findings, symptoms, EMG findings, and chemotherapeutic agents used in the treatment were evaluated retrospectively. RESULTS A total of 742 patients were included in the study, with 630 (84.90%) male and 112 (15.10%) female patients. Of the patients included in the study, 406 (54.71%) had positive sensorial symptoms, 494 (66.57%) had negative sensorial symptoms, 162 (21.83%) had motor symptoms, and 254 (34.23%) had pain symptoms. The patients were classified into two groups on the basis of the presence of polyneuropathy detected via EMG as group I (n = 500, 67.38%) including the patients with polyneuropathy and group II (n = 242, 32.61%) including the patients without polyneuropathy. Negative sensorial symptoms and motor symptoms in group I along with dysesthesia and paresthesia symptoms in group II were observed at ratios that were higher at a statistically significant level (p = 0.001, p = 0.001, p = 0.001, p = 0.001). CONCLUSION Sensorial symptoms are observed most frequently in chemotherapy-related peripheral neuropathies in lung cancer treatment and motor symptoms may also increase according to the chemotherapy regimen.
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Affiliation(s)
| | - Hakan Celikhisar
- Chest Diseases Clinic, Izmir Metropolitan Municipality Hospital, Izmir, Turkey
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Selvy M, Pereira B, Kerckhove N, Busserolles J, Farsi F, Guastella V, Merle P, Pezet D, Balayssac D. Prevention, diagnosis and management of chemotherapy-induced peripheral neuropathy: a cross-sectional study of French oncologists' professional practices. Support Care Cancer 2021; 29:4033-4043. [PMID: 33403401 DOI: 10.1007/s00520-020-05928-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Chemotherapy-induced peripheral neuropathy (CIPN) is challenging for oncologists. Many publications mention the high incidence of CIPN and the lack of effective preventive/management strategies and robust diagnostic tools. This cross-sectional study was aimed at assessing the practice of French oncologists for CIPN prevention, diagnosis and management. METHODS This web-based survey was sent to French oncologists by the regional cancer networks. Incidence and impact of CIPN were assessed using visual analogue scales (VAS) and diagnostic strategies were recorded. Also recorded were the drugs used to prevent or manage CIPN and their perceived efficacy and safety (VAS). RESULTS Among the 210 oncologists included, the perceived incidence of CIPN was about 36.2 ± 22.1% of patients. About 99.5% of oncologists declared that they assess CIPN during medical follow-up. The use of drugs to prevent CIPN was reported by 9.6% of oncologists (group B vitamins (35.0%) and calcium and magnesium infusion (25.0%)). In the case of CIPN, the therapeutic adjustment of neurotoxic anticancer drugs is performed by 99.0% of oncologists (chemotherapy change (49.8%), dose reduction (30.9%) or interruption (19.3%)). The pharmacological management of CIPN was declared by 72.9% of oncologists. The main drugs used are pregabalin (75.8%), amitriptyline (32.7%) and gabapentin (25.5%). Duloxetine (ASCO recommendation) is used by only 11.8% of oncologists. CONCLUSION Oncologists were clearly aware of CIPN risks, but its incidence tended to be underestimated and the ASCO recommendations for the management of CIPN were not followed. The prevention, diagnosis and management of CIPN remain problematic in clinical practice in France. TRIAL REGISTRATION ClinicalTrials.gov : NCT03854864.
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Affiliation(s)
- Marie Selvy
- CHU Clermont-Ferrand, INSERM U1107 NEURO-DOL, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Bruno Pereira
- Délégation de la recherche clinique et de l'innovation, Biostatistics Unit, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Nicolas Kerckhove
- CHU Clermont-Ferrand, INSERM U1107 NEURO-DOL, Institut ANALGESIA, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Jérôme Busserolles
- INSERM U1107 NEURO-DOL, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - Fadila Farsi
- Réseau Régional de Cancérologie ONCO-AURA, CRLCC Léon Bérard, F-69373, Lyon Cedex 08, France
| | - Virginie Guastella
- Service de soins palliatifs, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Patrick Merle
- Service de Pneumologie, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Denis Pezet
- INSERM U1071, M2iSH, USC-INRA 2018, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France
| | - David Balayssac
- CHU Clermont-Ferrand, INSERM U1107 NEURO-DOL, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France.
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Bouchenaki H, Danigo A, Sturtz F, Hajj R, Magy L, Demiot C. An overview of ongoing clinical trials assessing pharmacological therapeutic strategies to manage chemotherapy-induced peripheral neuropathy, based on preclinical studies in rodent models. Fundam Clin Pharmacol 2020; 35:506-523. [PMID: 33107619 DOI: 10.1111/fcp.12617] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 12/22/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting side effect induced by a variety of chemotherapeutic agents. Symptoms are mainly sensory: pain, tingling, numbness, and temperature sensitivity. They may require the tapering of chemotherapy regimens or even their cessation; thus, the prevention/treatment of CIPN is critical to increase effectiveness of cancer treatment. However, CIPN management is mainly based on conventional neuropathic pain treatments, with poor clinical efficacy. Therefore, significant effort is made to identify new pharmacological targets to prevent/treat CIPN. Animal modeling is a key component in predicting human response to drugs and in understanding the pathophysiological mechanisms underlying CIPN. In fact, studies performed in rodents highlighted several pharmacological targets to treat/prevent CIPN. This review provides updated information about ongoing clinical trials testing drugs for the management of CIPN and presents some of their proof-of-concept studies conducted in rodent models. The presented drugs target oxidative stress, renin-angiotensin system, glutamatergic neurotransmission, sphingolipid metabolism, neuronal uptake transporters, nicotinamide adenine dinucleotide metabolism, endocannabinoid system, transient receptor potential channels, and serotoninergic receptors. As some clinical trials focus on the effect of the drugs on pain, others evaluate their efficacy by assessing general neuropathy. Moreover, based on studies conducted in rodent models, it remains unclear if some of the tested drugs act in an antinociceptive fashion or have neuroprotective properties. Thus, further investigations are needed to understand their mechanism of action, as well as a global standardization of the methods used to assess efficacy of new therapeutic strategies in the treatment of CIPN.
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Affiliation(s)
- Hichem Bouchenaki
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.,Pharnext SA, Issy-les-Moulineaux, France
| | - Aurore Danigo
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Franck Sturtz
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | | | - Laurent Magy
- Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, Limoges, France
| | - Claire Demiot
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
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Long-Term Prevalence of Sensory Chemotherapy-Induced Peripheral Neuropathy for 5 Years after Adjuvant FOLFOX Chemotherapy to Treat Colorectal Cancer: A Multicenter Cross-Sectional Study. J Clin Med 2020; 9:jcm9082400. [PMID: 32727095 PMCID: PMC7465246 DOI: 10.3390/jcm9082400] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 12/11/2022] Open
Abstract
(1) Background: Oxaliplatin is among the most neurotoxic anticancer drugs. Little data are available on the long-term prevalence and consequences of chemotherapy-induced peripheral neuropathy (CIPN), even though the third largest population of cancer survivors is made up of survivors of colorectal cancer. (2) Methods: A multicenter, cross-sectional study was conducted in 16 French centers to assess the prevalence of CIPN, as well as its consequences (neuropathic pain, anxiety, depression, and quality of life) in cancer survivors during the 5 years after the end of adjuvant oxaliplatin chemotherapy. (3) Results: Out of 406 patients, the prevalence of CIPN was 31.3% (95% confidence interval: 26.8–36.0). Little improvement in CIPN was found over the 5 years, and 36.5% of patients with CIPN also had neuropathic pain. CIPN was associated with anxiety, depression, and deterioration of quality of life. None of the patients with CIPN were treated with duloxetine (recommendation from American Society of Clinical Oncology), and only 3.2%, 1.6%, and 1.6% were treated with pregabalin, gabapentin, and amitriptyline, respectively. (4) Conclusions: Five years after the end of chemotherapy, a quarter of patients suffered from CIPN. The present study showed marked psychological distress and uncovered a failure in management in these patients.
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Molassiotis A, Suen LKP, Cheng HL, Mok TSK, Lee SCY, Wang CH, Lee P, Leung H, Chan V, Lau TKH, Yeo W. A Randomized Assessor-Blinded Wait-List-Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy. Integr Cancer Ther 2019; 18:1534735419836501. [PMID: 30905173 PMCID: PMC6434440 DOI: 10.1177/1534735419836501] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose: Chemotherapy-induced peripheral neuropathy is a complex side effect with few available treatment options. The aim of the study was to test the effectiveness of an 8-week course of acupuncture in the management of chemotherapy-induced peripheral neuropathy in cancer patients who were receiving or had received neurotoxic chemotherapy. Methods: Randomized assessor-blinded controlled trial with 2 arms; one arm received acupuncture twice weekly for 8 weeks, while the other arm was a wait-list control group receiving only standard care. Primary outcome was pain intensity and interference over the past week using the Brief Pain Inventory at the end of the intervention. Secondary outcomes included clinical assessment (CTCAE [Common Toxicity Criteria for Adverse Events] grading and Total Neuropathy Score–Clinical Version) and nerve conduction studies; and patient-reported outcome measures (Functional Assessment of Cancer Therapy–Gynecologic Oncology Group–Neurotoxicity Quality of Life scale and Symptom Distress Scale) assessed at baseline, end of treatment (8 weeks), week 14, and week 20 from the beginning of treatment. Results: Eighty-seven patients were randomized to the experimental arm (n = 44) and to the standard care wait-list control arm (n = 43). Significant changes at 8 weeks were detected in relation to primary outcome (pain), the clinical neurological assessment, quality of life domains, and symptom distress (all P < .05). Improvements in pain interference, neurotoxicity-related symptoms, and functional aspects of quality of life were sustained in the 14-week assessment (P < .05), as were physical and functional well-being at the 20-week assessment (P < .05). Conclusions: Acupuncture is an effective intervention for treating chemotherapy-induced peripheral neuropathy and improving patients’ quality of life and experience with neurotoxicity-related symptoms with longer term effects evident.
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Affiliation(s)
| | - Lorna K P Suen
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Hui Lin Cheng
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - T S K Mok
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - Sara C Y Lee
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - C H Wang
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - Paul Lee
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Howan Leung
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - V Chan
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - T K H Lau
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - Winnie Yeo
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
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DaSilva JK, Arezzo JC. Use of Nerve Conduction Assessments to Evaluate Drug-Induced Peripheral Neuropathy in Nonclinical Species—A Brief Review. Toxicol Pathol 2019; 48:71-77. [DOI: 10.1177/0192623319873878] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The peripheral nervous system (PNS) is subject to a wide range of structural and functional insults including direct damage to axons, loss of myelin, and progressive deficits in saltatory conduction. Drugs that damage the PNS often result in neuropathies that impact the structure and function of targeted nerves. In most cases, both sensory and motor neurons are affected with damage initially evident in the distal extremities. Drug-induced neuropathies are potentially reversible following cessation of treatment, but early stages of neuropathy can be subclinical and asymptomatic making diagnosis difficult. Nerve biopsy is highly validated and provides definitive evidence of nerve injury and corresponding severity; however, it is limited in some respects and electrophysiological measures can complement histopathological assessments and provide a functional measure of potential toxicity. In a drug development setting, nerve conduction assessments are valuable to monitor nerve function longitudinally if nerve damage is suspected or confirmed, and importantly, can be used to monitor progression and/or recovery of a drug-induced neuropathy. This review will summarize the methodology used in nerve conduction assessments as well as discuss data interpretation and considerations for use in nonclinical species. Finally, the use of nerve conduction assessments in nonclinical drug development is discussed.
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Aydın Ş, Özdemir C, Turan SA, Başer Y, Kıyık M. Akciğer kanserinin tedavisinde periferiknöropati; Önemli bir komorbidite. DICLE MEDICAL JOURNAL 2019. [DOI: 10.5798/dicletip.620534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Alberti P. Platinum-drugs induced peripheral neurotoxicity: clinical course and preclinical evidence. Expert Opin Drug Metab Toxicol 2019; 15:487-497. [DOI: 10.1080/17425255.2019.1622679] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Paola Alberti
- NeuroMI (Milan Center for Neuroscience), Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Kerckhove N, Collin A, Condé S, Chaleteix C, Pezet D, Balayssac D, Guastella V. [Chemotherapy-induced peripheral neuropathy: Symptomatology and epidemiology]. Bull Cancer 2018; 105:1020-1032. [PMID: 30244980 DOI: 10.1016/j.bulcan.2018.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 06/27/2018] [Accepted: 07/05/2018] [Indexed: 12/18/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is common with specific semiological characteristics. When CIPN appears, there are many difficulties in guaranteeing sustained treatment, especially with optimal protocol. Moreover, CIPN have bad repercussions on quality of life after cancer disease. In this article, we have achieved a current state of CIPN and try to report details about semiological characteristics and topography. We have also produced some epidemiological data. Nonetheless, we have not voluntarily introduced treatment because it will be the topic of further work.
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Affiliation(s)
- Nicolas Kerckhove
- Délégation à la recherche clinique et à l'innovation, CHU de Clermont-Ferrand, université Clermont-Auvergne, NEURO-DOL, Inserm U1107, 2, rue Braga, 63100 Clermont-Ferrand, France
| | - Aurore Collin
- Université Clermont-Auvergne, NEURO-DOL, Inserm U1107, 2, rue Braga, 63100 Clermont-Ferrand, France
| | - Sakhalé Condé
- CHU de Clermont-Ferrand, université Clermont-Auvergne, neurologie, NEURO-DOL, Inserm U1107, 2, rue Braga, 63100 Clermont-Ferrand, France
| | - Carine Chaleteix
- CHU de Clermont-Ferrand, hématologie clinique adulte, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand, France
| | - Denis Pezet
- CHU Clermont-Ferrand, université Clermont-Auvergne, chirurgie et oncologie digestive, Inserm U1071, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
| | - David Balayssac
- Délégation à la recherche clinique et à l'innovation, CHU de Clermont-Ferrand, université Clermont-Auvergne, NEURO-DOL, Inserm U1107, 2, rue Braga, 63100 Clermont-Ferrand, France
| | - Virginie Guastella
- CHU de Clermont-Ferrand, centre de soins palliatifs, route de Chateaugay, 63118 Cébazat, France.
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Alberti P, Rossi E, Argyriou AA, Kalofonos HP, Briani C, Cacciavillani M, Campagnolo M, Bruna J, Velasco R, Cazzaniga ME, Cortinovis D, Valsecchi MG, Cavaletti G. Risk stratification of oxaliplatin induced peripheral neurotoxicity applying electrophysiological testing of dorsal sural nerve. Support Care Cancer 2018; 26:3143-3151. [DOI: 10.1007/s00520-018-4170-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 03/19/2018] [Indexed: 01/23/2023]
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12
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Kerckhove N, Collin A, Condé S, Chaleteix C, Pezet D, Balayssac D. Long-Term Effects, Pathophysiological Mechanisms, and Risk Factors of Chemotherapy-Induced Peripheral Neuropathies: A Comprehensive Literature Review. Front Pharmacol 2017; 8:86. [PMID: 28286483 PMCID: PMC5323411 DOI: 10.3389/fphar.2017.00086] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 02/09/2017] [Indexed: 12/29/2022] Open
Abstract
Neurotoxic anticancer drugs, such as platinum-based anticancer drugs, taxanes, vinca alkaloids, and proteasome/angiogenesis inhibitors are responsible for chemotherapy-induced peripheral neuropathy (CIPN). The health consequences of CIPN remain worrying as it is associated with several comorbidities and affects a specific population of patients already impacted by cancer, a strong driver for declines in older adults. The purpose of this review is to present a comprehensive overview of the long-term effects of CIPN in cancer patients and survivors. Pathophysiological mechanisms and risk factors are also presented. Neurotoxic mechanisms leading to CIPNs are not yet fully understood but involve neuronopathy and/or axonopathy, mainly associated with DNA damage, oxidative stress, mitochondria toxicity, and ion channel remodeling in the neurons of the peripheral nervous system. Classical symptoms of CIPNs are peripheral neuropathy with a “stocking and glove” distribution characterized by sensory loss, paresthesia, dysesthesia and numbness, sometimes associated with neuropathic pain in the most serious cases. Several risk factors can promote CIPN as a function of the anticancer drug considered, such as cumulative dose, treatment duration, history of neuropathy, combination of therapies and genetic polymorphisms. CIPNs are frequent in cancer patients with an overall incidence of approximately 38% (possibly up to 90% of patients treated with oxaliplatin). Finally, the long-term reversibility of these CIPNs remain questionable, notably in the case of platinum-based anticancer drugs and taxanes, for which CIPN may last several years after the end of anticancer chemotherapies. These long-term effects are associated with comorbidities such as depression, insomnia, falls and decreases of health-related quality of life in cancer patients and survivors. However, it is noteworthy that these long-term effects remain poorly studied, and only limited data are available such as in the case of bortezomib and thalidomide-induced peripheral neuropathy.
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Affiliation(s)
- Nicolas Kerckhove
- INSERM U1107, NEURO-DOL, CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Université Clermont Auvergne Clermont-Ferrand, France
| | - Aurore Collin
- INSERM U1107, NEURO-DOL, Université Clermont Auvergne Clermont-Ferrand, France
| | - Sakahlé Condé
- INSERM U1107, NEURO-DOL, CHU Clermont-Ferrand, Neurologie, Université Clermont Auvergne Clermont-Ferrand, France
| | - Carine Chaleteix
- CHU Clermont-Ferrand, Hématologie Clinique Adulte Clermont-Ferrand, France
| | - Denis Pezet
- INSERM U1071, CHU Clermont-Ferrand, Chirurgie et Oncologie Digestive, Université Clermont Auvergne Clermont-Ferrand, France
| | - David Balayssac
- INSERM U1107, NEURO-DOL, CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Université Clermont Auvergne Clermont-Ferrand, France
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