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Oxaliplatin-Related Neuropathy and Diabetic Neuropathy Appear Not to Be Additive in Comorbid Colorectal Cancer and Diabetes: Presented at ICACT

By Shazia Qureshi

PARIS, FRANCE -- February 11, 2008 -- Neuropathy resulting from treatment with oxaliplatin does not appear to be additive in patients with diabetic neuropathy, researchers reported here at the 19th International Congress on Anti-Cancer Treatment (ICACT).

"Oxaliplatin can be administered in [patients with] diabetes," said lead investigator Vittorio Ferrari, MD, Oncologist, Oncology Unit and Beretta Foundation, Azienda Spedali Civili, Brescia, Italy, who presented the findings of this study in a poster on February 6.

Dr. Ferrari and his colleagues administered one course of oxaliplatin chemotherapy to 653 patients with colorectal cancer from January 2001 to December 2006. A subgroup of 9 patients who were diagnosed at baseline with diabetes and 25 patients with prediabetes according to American Diabetes Association criteria were analysed for presence of neurotoxicities.

Diabetes was defined as a fasting plasma glucose (FPG) level of 126 mg/dL or higher; prediabetes was a FPG 105 to 125 mg/dL. Dukes' classification of the colorectal cancer was B2 in 6 patients, C in 27 patients, and D in 1 patient. Nine patients were women, and the median age of the 34 patients was 65 years (range 47-78 years).

The researchers identified 32 patients with neuropathy. Patients had multiple symptoms of neurotoxicity, including paraesthesia (49 incidents), hiccup (3 incidents), headache (3 incidents), dizziness (3 incidents), ear ache (2 incidents), face neuralgia (1 incident), and scotoma (1 incident). Of the 49 incidents of paraesthesia, 24 were in the hand, 11 in the foot, 2 in the mouth, 5 in the face, and 7 were in the pharynx.

Dr. Ferrari and his colleagues noted that 16.3% of adverse events were grade 3/4 neurotoxicities. Using the chi-squared test and univariate statistical analyses, they evaluated the correlations between patients' characteristics (such as age, cancer stage, cumulative chemotherapy dose, serum haemoglobin levels) and the occurrence of paraesthesias.

The only correlation that was significant was between cumulative oxaliplatin dose and paraesthesia occurrence (P =.036), a known potential adverse effect associated with oxaliplatin treatment.

When the researchers compared this subgroup with the 653 patients who did not have diabetes or prediabetes, they found that these conditions did not increase the risk of neuropathy. This was despite the fact that neuropathy is a known complication of diabetes.

Dr. Ferrari suggested that the neuropathy resulting oxaliplatin or diabetic neuropathy may be occurring at different times. He concluded that it appears that oxaliplatin can be given to patients with comorbid colorectal cancer and diabetes.


[Poster title: Neurotoxicity in Colorectal Cancer Diabetic's Patients Treated With Oxaliplatin (OX). Abstract PO77]

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