NEUROTOXICITY IN OVARIAN CANCER

Gynecol Oncol. 2014 Dec 18. pii: S0090-8258(14)01576-5. doi: 10.1016/j.ygyno.2014.12.021. [Epub ahead of print]

Neurotoxicity in ovarian cancer patients on Gynecologic Oncology Group (GOG) protocol 218: Characteristics associated with toxicity and the effect of substitution with docetaxel: An NRG Oncology/Gynecologic Oncology Group study.

Chase DM1, Huang H2, Foss CD3, Wenzel LB4, Monk BJ5, Burger RA6.

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Abstract

OBJECTIVES: 

To describe characteristics associated with neurotoxicity (NT) in advanced ovarian cancer patients treated on Gynecologic Oncology Group 218 and examine effect of substituting docetaxel for paclitaxel in these patients.

METHODS: 

The development of NT was defined as Common Toxicity Criteria grade (G)≥1. The association between substitution with docetaxel and NT improvement was explored with generalized estimating equations adjusting for treatment cycle and NT grading at previous cycle.

RESULTS: 

Of 1864 evaluable patients, 1329 (71%) developed G≥1 NT during the study. Nearly half appeared within the first two cycles of chemotherapy, with 31% experiencing G≥2. Older patients or those with worse quality of life (QoL) scores at baseline (p<0 .05="" 0.98-2.54="" 1.57="" 2-6="" 47="" 59="" 95="" although="" and="" as="" at="" ci="" continued="" cycle="" dds="" despite="" docetaxel="" due="" during="" evidence="" experience="" fear="" for="" g="" improved="" instructed="" likely="" majority="" more="" n="8)." no="" nt.="" nt="" of="" one-hundred-six="" one="" other="" otherwise="" p="" paclitaxel.="" paclitaxel="" patients="" protocol="" ratio:="" reaction="" reasons="" received="" started="" substitute="" substitution="" switched="" symptoms.="" that="" the="" them="" there="" to="" was="" were="" whereas="" with="">0.05). Of 59 patients who switched to docetaxel, only seven (12%) discontinued taxane prior to chemotherapy completion. A roughly equal chance of worsening NT was reported on paclitaxel (6%) as on docetaxel (5%).

CONCLUSIONS: 

Age and worse QoL at baseline are associated with NT. Substitution of docetaxel did not improve NT symptoms.