PO102 PACLITAXEL INDUCED CIPN – CAN IT BE CONTROLLED?

Abstract

peripheral sensory disturbance and the peripheral blood flow. In our attempts to treat peripheral neuropathy, we have applied two concepts: compression therapy using stockings and sleeves and prophylactic therapy, including goshajinkigan, to control adverse nonhematologic effects due to nab-PTX for breast cancer. Aim: This study aimed to elucidate whether prophylactic treatment, including stockings, sleeves and certain drugs (3S), is effective for preventing nab-PTX-induced peripheral neuropathy. Patients and Methods: Fourteen patients with recurrent, metastatic or locally advanced breast cancer were included and treated with nabPTX at a dose of 260 mg/m2 every three weeks at our hospital from June 2012 to April 2013. The patients were divided into two groups: a prophylactic treatment (3S) group (n=7) and a control group (n=7). In the 3S group, the patients wore stockings and sleeves from the beginning of nab-PTX administration for 24 hours and concurrently received prophylactic drugs, including goshajinkigan (7.5 g/day), mecobalamin (1,500 μg/day) and lafutidine (20 mg/day). The grade of peripheral neuropathy evaluated according to the definition of CTCAE v4.0 and total administered dose were compared between the two groups. Results: After the initial treatment with nab-PTX, peripheral neuropathy appeared in five of the seven patients in the control group and in only one of seven patients in the 3S group (p = 0.014). After four cycles of nab-PTX, the grade of peripheral neuropathy in the 3S group was better than that observed in the control group (p < 0.01). The mean dose in the 3S group was 86.7 mg/m2/week, which is significantly better than that observed in the control group (63.4 mg/m2/week, p< 0.01). Conclusions: 3S treatment controls the grade of neuropathy, resulting in the maintenance of the total dose of nab-PTX in breast cancer patients.