Efficacy of oxcarbazepine for prophylaxis against cumulative oxaliplatin-induced neuropathy

School of Medicine, University of Patras, Rhion, West Greece, Greece
Neurology (Impact Factor: 8.29). 01/2007; 67(12):2253-5. DOI: 10.1212/01.wnl.0000249344.99671.d4
Source: PubMed


We conducted a randomized, open-label, controlled trial to assess the efficacy of oxcarbazepine for prophylaxis against oxaliplatin-induced peripheral neuropathy (OxIN). Thirty-two patients with colon cancer received 12 courses of the FOLFOX-4 regimen and were randomly assigned to receive oxcarbazepine (600 mg BID) or chemotherapy without oxcarbazepine. The incidence of OxIN was strikingly decreased in patients receiving oxcarbazepine (31.2% vs 75%). Oxcarbazepine may prevent OxIN symptoms. Further larger placebo-controlled trials are warranted to confirm our results.

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Available from: Philippos Gourzis, Aug 27, 2015
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    • "Impairment of sodium channel function is one of the probable mechanisms responsible for neuronal damage accompanying oxaliplatin therapy [36–38]. Since carbamazepine inhibits the activity of these channels, attempts were made to apply the drug to prevent CIPN. "
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    ABSTRACT: The incidence of chemotherapy-induced peripheral neuropathy (CIPN) in the population of cancer patients is estimated at 3–7% in cytostatic monotherapy and as high as 38% in the case of polytherapy. While testing drugs that may reduce the damage to the peripheral nervous system, particular attention should be paid to their protective action against the severe and painful complication in the patient. Another aspect, perhaps a more important one, is the confidence that application of preventive drugs will not exert a significant impact on progression of the neoplastic disease or the effectiveness of the causal treatment. Many drugs have been tested for prevention of CIPN; however, none of them have thus far been irrefutably proven to possess preventive properties. No guidelines on chemotherapy-induced peripheral neuropathy preventive action have been established, either. This article is an attempt to present reports from the available literature about the possibilities of prevention of CIPN.
    Contemporary Oncology / Wspólczesna Onkologia 07/2012; 16(3):258-261. DOI:10.5114/wo.2012.29296 · 0.22 Impact Factor
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    • "Gabapentin was also ineffective when tried as a preventative measure in a randomised trial [50]. Oxcarbazepine, an analogue of carbamazepine, was effective in a small randomized trial in preventing OXIN [49], but larger confirmatory trials are required. "
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    ABSTRACT: Oxaliplatin use in palliative and adjuvant treatment of colon cancer is frequently limited by cumulative neurotoxicity, leading to reduced quality of life and decreased dose. The mechanism of this neurotoxicity is unclear, but may relate to neuronal voltage-gated sodium channels involving calcium chelation by a metabolite of the drug. Various preventative measures have been tested to reduce the incidence of neurotoxicity, including calcium and magnesium infusions, dose interruption of the drug, and prophylactic neuromodulatory agents. Despite the promising efficacy of these measures, they are not universally accepted. Less is known about the best way to treat established neurotoxicity, which is permanent in some patients, although venlafaxine has shown promise in small clinical trials. This paper analyzes the extent, cause and risk factors for neuropathy, and the potential preventative and therapeutic treatments for oxaliplatin-induced neuropathy.
    Journal of Oncology 12/2011; 2011(1):201593. DOI:10.1155/2011/201593
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    • "However, this Phase II trial was designed to accrue 51 patients to each treatment group but only 19 patients received carbamazepine and 17 did not; therefore, this trial was significantly underpowered. Argyriou et al (2006c) evaluated oxcarbazepine in patients treated with oxaliplatin in a pilot, randomized, but not placebo-controlled trial. Oxcarbazepine affects both sodium and calcium channels and therefore may be more effective. "
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    ABSTRACT: Chemotherapy-induced peripheral neuropathy (CIPN) is still a common and disabling side effect of many chemotherapy agents in use today. Unfortunately, neither prophylactic strategies nor symptomatic treatments have proven useful yet. This review will discuss the diagnosis and evaluation of neuropathy in cancer patients, as well as reviewing the various prophylactic and symptomatic treatments that have been proposed or tried. However, sufficient evidence is lacking to recommend any of these treatments to patients suffering with CIPN. Therefore, the best approach is to treat symptomatically, and to start with broad-spectrum analgesic medications such as non-steroidal anti-inflammatory drugs (NSAIDs). If NSAIDs fail, a reasonable second-line agent in properly selected patients may be an opioid. Unfortunately, even when effective in other types of neuropathic pain, anti-depressants and anticonvulsants have not yet proven effective for treating the symptoms of CIPN.
    British Journal of Haematology 02/2009; 145(1):3-14. DOI:10.1111/j.1365-2141.2008.07558.x · 4.71 Impact Factor
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