Baseline Peripheral Neuropathy Predicts Clinically Significant Neuropathy During Paclitaxel Treatment Following Oxaliplatin-based Chemotherapy.
- 1Faculty of Pharmaceutical Sciences, Kinjo Gakuin University, Nagoya, Japan.
- 2Department of Pharmacy, Ogaki Municipal Hospital, Ogaki, Japan.
Abstract
Background/aim
Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity that adversely affects quality of life and treatment continuity of patients with malignancy. Although cumulative oxaliplatin exposure is a recognized risk factor for neurotoxicity, it remains unclear whether cumulative exposure or baseline neurological status better predicts clinically significant CIPN during subsequent paclitaxel treatment. This study aimed to identify predictors of clinically significant CIPN during paclitaxel therapy, focusing on the relative predictive value of cumulative oxaliplatin exposure and baseline CIPN.Patients and methods
We retrospectively reviewed 76 patients with advanced gastric cancer who received paclitaxel-based second-line therapy after oxaliplatin-containing first-line chemotherapy. The primary endpoint was time to development of grade ≥2 CIPN, and the secondary endpoint was CIPN worsening. Cox proportional hazards and multivariable logistic regression analyses were performed to identify factors associated with CIPN progression.Results
Grade ≥2 CIPN developed in 34 patients (44.7%). Baseline CIPN (grade 1 vs. 0) independently predicted subsequent grade ≥2 CIPN (hazard ratio=4.23, 95% confidence interval=1.67-10.72; p=0.002; odds ratio=5.00, 95% confidence interval=1.58-15.80; p=0.006). In contrast, cumulative oxaliplatin dose was not associated with grade ≥2 CIPN or CIPN worsening. Kaplan-Meier analysis also showed no association between cumulative oxaliplatin dose and time to CIPN worsening, whereas higher serum albumin levels tended to be associated with a lower risk of CIPN progression.Conclusion
Baseline CIPN was a stronger predictor of clinically significant neuropathy during paclitaxel treatment than prior cumulative oxaliplatin exposure. Routine assessment of baseline neurological status before paclitaxel initiation may help identify patients at high risk for clinically significant CIPN and support individualized treatment and monitoring strategies.
Related
- "It's Like a Marathon": A Qualitative Study of Symptom Burden and Adaptation Among Patients with Oxaliplatin-Induced Peripheral Neuropathy During Treatment.
- Emerging Therapeutic Targets in Oxaliplatin-Induced Acute Peripheral Neuropathy: Biochemical Protection by Organoselenium via Redox and Ionic Regulation.
- Zdhhc14 promotes pyroptosis in the dorsal root ganglion of oxaliplatin‐induced peripheral neuropathy mice by enhancing GBP5 palmitoylation and suppressing its ubiquitination
- Impact of neuropathy severity on hand function, strength, and dexterity in patients with oxaliplatin-induced peripheral neuropathy.
- Topical herbal medicine as treatment for chemotherapy-induced peripheral neuropathy: a systematic review of randomized controlled trials
BibTeX
@article{tomiuchi2026baseline,
title = {{Baseline Peripheral Neuropathy Predicts Clinically Significant Neuropathy During Paclitaxel Treatment Following Oxaliplatin-based Chemotherapy.}},
author = {Aiko Tomiuchi and Michio Kimura and Yoshiaki Ikeda and Eiseki Usami},
journal = {Cancer diagnosis \& prognosis},
year = {2026},
month = nov,
doi = {10.21873/cdp.10599},
url = {https://europepmc.org/article/MED/42968917},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Baseline Peripheral Neuropathy Predicts Clinically Significant Neuropathy During Paclitaxel Treatment Following Oxaliplatin-based Chemotherapy.
AU - Aiko Tomiuchi
AU - Michio Kimura
AU - Yoshiaki Ikeda
AU - Eiseki Usami
PY - 2026
DA - 2026/11/01
JO - Cancer diagnosis & prognosis
DO - 10.21873/cdp.10599
UR - https://europepmc.org/article/MED/42968917
AB - Background/aim Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity that adversely affects quality of life and treatment continuity of patients with malignancy. Although cumulative oxaliplatin exposure is a recognized risk factor for neurotoxicity, it remains unclear whether cumulative exposure or baseline neurological status better predicts clinically significant CIPN during subsequent paclitaxel treatment. This study aimed to identify predictors of clinically significant CIPN during paclitaxel therapy, focusing on the relative predictive value of cumulative oxaliplatin exposure and baseline CIPN.Patients and methods We retrospectively reviewed 76 patients with advanced gastric cancer who received paclitaxel-based second-line therapy after oxaliplatin-containing first-line chemotherapy. The primary endpoint was time to development of grade ≥2 CIPN, and the secondary endpoint was CIPN worsening. Cox proportional hazards and multivariable logistic regression analyses were performed to identify factors associated with CIPN progression.Results Grade ≥2 CIPN developed in 34 patients (44.7%). Baseline CIPN (grade 1 vs. 0) independently predicted subsequent grade ≥2 CIPN (hazard ratio=4.23, 95% confidence interval=1.67-10.72; p=0.002; odds ratio=5.00, 95% confidence interval=1.58-15.80; p=0.006). In contrast, cumulative oxaliplatin dose was not associated with grade ≥2 CIPN or CIPN worsening. Kaplan-Meier analysis also showed no association between cumulative oxaliplatin dose and time to CIPN worsening, whereas higher serum albumin levels tended to be associated with a lower risk of CIPN progression.Conclusion Baseline CIPN was a stronger predictor of clinically significant neuropathy during paclitaxel treatment than prior cumulative oxaliplatin exposure. Routine assessment of baseline neurological status before paclitaxel initiation may help identify patients at high risk for clinically significant CIPN and support individualized treatment and monitoring strategies.
SN - 2732-7787
ER -