Sixth Course Research Articles

Frequency of and sex differences in cancer treatment-related cardiac dysfunction in trastuzumab-treated patients with salivary gland cancer: a retrospective cohort study

BackgroundTrastuzumab treatment for salivary gland, gastric, and breast cancer commonly causes cancer treatment-related cardiac dysfunction (CTRCD). CTRCD incidence by sex has not been well studied.MethodsThis retrospective cohort study investigated frequency of and sex differences in CTRCD in patients with salivary gland cancer treated with trastuzumab at our hospital from April 2017 to March 2022. All patients underwent echocardiography at baseline and after the first, third, and sixth trastuzumab courses. We measured changes in global and regional longitudinal strain (LS) after trastuzumab administration. CTRCD was defined by left ventricular ejection fraction (LVEF) or global LS (GLS). The results were compared by sex.ResultsWe recorded clinical data of 49 patients (median age [IQR], 65 [55–71] years; males [75.5%]). The median follow-up period after the sixth trastuzumab course was 120 (111–128) days. One female patient and no male patient had CTRCD defined by LVEF, and two female patients (16.7%) and seven male patients (18.9%) had CTRCD, defined by GLS. The Kaplan–Meier curves showed no significant difference in CTRCD frequency, defined by GLS (log-rank, p = 0.88), between female and male patients. In the univariate analysis, sex was not associated with CTRCD, defined by GLS. A significant difference in apical LS was observed between baseline and the third follow-up results of male patients.ConclusionsIn this study, CTRCD incidence was not significantly different between male and female patients with salivary gland cancer treated with trastuzumab. Although most previous studies have looked at female patients with breast cancer, a male patient may be found to be at similar risk of myocardial damage.

Phase II study of the safety and efficacy of discontinuing pegfilgrastim for pancreatic adenocarcinoma treated with FOLFIRINOX.

663 Background: The original FOLFIRINOX regimen (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) for pancreatic ductal adenocarcinoma (PDAC) is associated with a high risk of febrile neutropenia (FN), and pegfilgrastim has been used to reduce the risk. However, it remains unclear how long pegfilgrastim needs to continue. This study evaluated the safety and efficacy of FOLFIRINOX after discontinuing pegfilgrastim in PDAC patients. Methods: This prospective phase II trial included patients with PDAC who received the first three courses of FOLFIRINOX, with primary pegfilgrastim prophylaxis for FN, and did not experience FN. The patients continued on FOLFIRINOX without pegfilgrastim from the fourth course. The primary endpoint was development of FN. The secondary endpoints included relative dose intensity (RDI), objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). The threshold and expected development of FN were 20% and 7%, respectively, at a one-sided significance level of 0.10 and statistical power of 80%. Based on this hypothesis, we calculated the number of patients needed to be 33. Results: In total, 34 patients (20 male, median age 66 years) were enrolled from August 2017 to September 2021. Twenty-three patients were unresectable, and 11 were borderline resectable. FN developed in one patient. Grade 4 neutropenia was observed in six patients, grade 3 neutropenia in 10 (29.4%), anemia in four (11.8%), diarrhea in two (5.9%), and malaise, lung infection, peripheral sensory neuropathy, colitis, and biliary tract infection in one (2.9%) each. Twenty-two patients required dose reduction, mainly because of neutropenia. Mean RDIs at the sixth course of oxaliplatin, irinotecan, leucovorin, acute infusion of fluorouracil, and continuous infusion of fluorouracil were 77.0%, 88.2%, 81.8%, 84.4%, and 87.6%, respectively. ORR, median PFS, and median OS were 44.1%, 15.8 months, and 25.8 months, respectively. Conclusions: FOLFIRINOX can be continued safely with a low incidence of FN after discontinuing pegfilgrastim in PDAC patients who did not experience FN during the first three courses of FOLFIRINOX, if the drug dose is reduced appropriately for neutropenia from the fourth course. Clinical trial information: UMIN000028055 .

Immunotherapeutic options for management of metastatic cervical cancer

Cervical cancer (CC) remains one of the common tumour diseases of women. It accounts for 9.8% of all neoplasia in women. The Food and Drug Administration approved pembrolizumab with PD-1 inhibitor antibodies for the treatment of RSM following the KEYNOTE-158 clinical trial. PD-L1/PD-1 inhibitors have shown promising results against objective response rate in female patients with CC. A clinical case of pembrolizumab treatment of a patient with metastatic CC with progression after radiotherapy and pelvic organ evisceration is described. The patient underwent IHC examination of the tumour material and was found to have PDL1 expression of more than 1% according to the 22C3 antibody assay. According to the instructions for Pembroria® it was decided to start systemic chemotherapy in the regimen of paclitaxel 175 mg/m2, carboplatin AUC5 and pembrolizumab at a dose of 200 mg every three weeks. After the third course, a control MRI study was performed. A partial response according to iRECIST criteria was confirmed. After the sixth course of therapy cytostatics were cancelled, the patient continued monotherapy with pembrolizumab 200 mg once every three weeks. At the control MRI after 10 months of therapy, the tumour conglomerate in the right hindbrain fossa was not detected and a complete response was confirmed. In the given observation anti-PD1 therapy and metastatic CC allowed to achieve complete remission of the disease. Thus, the clinical observation demonstrates the efficacy of pembrolizumab therapy in patients with advanced CC.

Incidence and Timing of Immune-Related Adverse Events in Immune-Checkpoint Inhibitor-Treated Patients: A Retrospective Observational Study.

Immune-checkpoint inhibitors (ICIs) are effective against various cancers; however, immune-related adverse events (irAEs) have been reported and the timing and risk factors are unknown. Therefore, we examined the incidence and timing of irAE occurrence. Patients who received ICIs at our hospital between 1 April 2016 and 31 March 2020 were enrolled. Patients were classified into an irAE group or non-irAE group. In addition, we examined the onset time and symptoms of irAEs for each ICI type. A total of 80 patients received ICIs, of which 27 (33.8%) developed irAEs. The incidence of irAEs was 35.3% for nivolumab, 35.5% for pembrolizumab, and 28.6% for atezolizumab. The incidence of pneumonitis was 12.5%, 8.8% for dermatologic adverse events, and 6.3% for thyroid dysfunction. The earliest case of onset was after the 1st course, and the latest cases occurred after the 66th course. By the sixth course, 69% of the irAEs occurred. The positive rates for anti-thyroid peroxidase and anti-thyroglobulin antibodies were higher in the irAE group compared to the non-irAE group. Our findings suggest a high probability of irAEs occurring early in ICI treatment, with a diverse range of symptoms. This underscores the need for vigilant monitoring and tailored patient management during the initial courses of ICI therapy.

Emetogenicity and Risk Factors of Nausea and Vomiting in Patients With Metastatic Colorectal Cancer Receiving Trifluridine/Tipiracil and Bevacizumab Chemotherapy.

Although combination chemotherapy with trifluridine/tipiracil (TAS-102) and bevacizumab (BEV) is highly effective for metastatic unresectable colorectal cancer (mCRC), this combination chemotherapy often induces nausea and vomiting. To identify risk factors for nausea and vomiting, we investigated the occurrence of nausea and vomiting in mCRC patients treated with TAS-102 and BEV. Study patients with mCRC received TAS-102 and BEV between March 2016 and December 2021. The status of nausea, vomiting, and antiemetic measures in each course were investigated, and factors involved in the occurrence of nausea and vomiting were analysed by logistic regression analysis. Data from 57 patients were analysed. The incidence rates of nausea and vomiting during the overall period were 57.9% and 17.5%, respectively. Nausea and vomiting were frequent not only in the early courses but also after the sixth course. Multivariate logistic regression analysis showed that the experience of nausea and vomiting in previous treatment with other agents was significantly associated with nausea and vomiting with TAS-102 and BEV. The experience of nausea and vomiting in previous treatment was associated with increased risk for nausea and vomiting in mCRC patients treated with TAS-102 and BEV.

“Activity based teaching learning in Engineering Education, a course on: Embedded Systems”

The activity-based teaching and learning approach is presented in this paper for undergraduate engineering students. The primary goal of this undertaking is to maximize the student learning. The conventional teaching-learning environment induces monotonicity due to repetitive nature of teaching and absence of activities which does not provide much beneficial effects on increasing students’ levels of knowledge. The activity-based teaching-learning circumvents the shortcomings of the conventional approach in transmission of educational content. In this paper, various modes of progressive pedagogy to increase the student participation in active learning are explored. Activity based teaching-learning is anything related to course in which all the students in a class to participate actively rather than to simply sit, watch, listen and take notes. This paper explains various activities developed and practiced in order to accomplish the goal. The activities described in this paper were implemented with the students majoring in Electronics and Communication Engineering (ECE) in their sixth semester mandatory course called "Embedded Systems". After examining the efficacy of the activities it was observed that the recommended strategy of active learning offers additional possibilities to learn outside of the traditional classroom setting. The performance of the Continuous Internal Evaluation (CIE) serves as the metric for determining the effectiveness of these activities. Keywords— Activity-based teaching, learning approach, Electronics and Communication Engineering, embedded systems

Written, Audio, and Video Feedback: Learning Outcomes and Community of Inquiry Model in Online Learning Curriculum

Traditionally, instructors give feedback in written form, however this mode of feedback can be vague and lack clear examples. Alternative modes of feedback such as audio and video can help students achieve increased comprehension and result in greater sense of belonging in the program or class. Therefore, the aim of this study was to evaluate the various modes of feedback delivery in an online class within a hybrid-learning curriculum and the impact on learning outcomes, effectiveness, and student experience. Participants included a convenience sample of 32 students enrolled in a sixth term course delivered fully online. The Community of Inquiry (CoI) Framework survey was completed after informed consent at the end of the term. Descriptive statistics and Kruskal-Wallis tests were utilized in data analysis. No significant difference was found when comparing mode of feedback with final course and exam grade (p=0.369 and p=0.280). Total mean (SD) of the CoI was highest in the term where video feedback was utilized with a mean score of 4.45(+0.473). Future research involving the CoI and mode of feedback should include comparing differing assignments and optimal quality and quantity that is provided to students.

A case of percutaneous transhepatic stomal varices embolization and partial splenic artery embolization for rectal cancer after CAPOX/BEV chemotherapy: the summary of the stomal varices related to oxaliplatin administration

Capecitabine and oxaliplatin (CAPOX) plus bevacizumab (BEV) therapy (CAPOX/BEV) is a standard treatment recommended as the first-line treatment for colorectal cancer recurrence. Recently, sinusoidal obstruction syndrome (SOS) and resulting portal hypertension have been reported as important side effects of oxaliplatin. We herein report a rectal cancer patient who underwent percutaneous transhepatic stoma variceal embolization (PTO) and partial splenic artery embolization (PSE) for stomal variceal bleeding and splenomegaly due to portal hypertension caused by SOS after CAPOX therapy. A 43-year-old man who underwent robot-assisted laparoscopic abdominoperineal resection for advanced lower rectal cancer was started on CAPOX/BEV therapy for early recurrence 1 month after surgery. In the sixth course, splenomegaly rapidly worsened, stomal varices appeared, and the stoma began bleeding. At 5 months after the appearance of stomal varices, the splenomegaly worsened, the frequency of stomal bleeding increased, and PTO was performed. Five months later, PSE was performed for splenomegaly and thrombocytopenia. At 5 months since the PSE, the stoma bleeding has not recurred, and the thrombocytopenia has been corrected. The patient has been able to continue chemotherapy. We suggest that staged treatment by PTO and PSE be considered an important treatment option for stomal varices and splenomegaly associated with SOS.

Predictive role of NKCD56bright cells in monitoring the progression of chronic lymphocytic leukemia during treatment

Standard treatment for chronic lymphocytic leukemia (CLL) has experienced a dramatic change over the last few years. Until recently, CLL was treated using chemoimmunotherapy (CIT) with anti-CD20 monoclonal antibodies. Even though novel agents such as BTKi (Bruton Tyrosine Kinase inhibitor) and BCL2 inhibitors are the standard of care in most therapeutic settings, CIT still has its place in CLL treatment. Interestingly, little is known about its effects on the immune system of patients with CLL. Contrary to the reduction of the number of CLL cells during CIT administration, little attention has been paid to the cellular microenvironment, the evaluation of which during treatment may provide additional information about the course of the disease and prognosis and therefore was set as the aim of this study. Flow cytometry was used to evaluate the phenotypes of different populations and subpopulations of lymphocytes in the peripheral blood (PB) of 20 patients with CLL before, during, and after CIT. During the CIT with R-FC (Rituximab, Fludarabine, and Cyclophosphamide) and R-B (Rituximab, Bendamustine) regimens, the sizes of the assessed populations and subpopulations of lymphocytes were dramatically reduced. Twenty-eight days after the first course of treatment, the exponential decrease of CLL cells was observed, and their number had declined to the median level of 10% of the numbers observed before the treatment. T cells, NK cells, NKCD56dim, NKT-like, and NKT-like CD56dim also decreased exponentially. After the second treatment course, a decline in the numbers of T, NK, NKCD56dim, NKT-like, and NKT-like CD56dim cells was observed, which were stable until the sixth treatment course. However, the number of NKT-like CD56bright cells decreased to the third course of treatment and then increased. The number of CLL cells in peripheral blood correlated with the number of NKCD56bright cells, influencing the treatment response. Upon CIT, the reduction of CLL cells is accompanied by shifts in immune cell populations, T, NK, and NKT-like cells. Monitoring changes of those cell populations in the peripheral blood may serve as an important predictive and prognostic indicator.

Evaluation of the Concentration of Selected Elements in Patients with Cancer of the Reproductive Organs with Respect to Treatment Stage-Preliminary Study.

(1) Background: The aim of this study was to assess the concentrations of selected elements in female patients with cancer of the reproductive organs, taking into account the stage of treatment. (2) Methods: The study sample consisted of 51 patients with advanced endometrial cancer and ovarian cancer, undergoing chemotherapy. The median age of the studied patients with endometrial cancer was 66.0 years (IQR: from 60.75 to 70.25), and with ovarian cancer―60.0 years (IQR: from 49.0 to 64.0). Each of the qualified women, after consent to participate in the study, had her blood drawn several times (before surgery, the first course of chemotherapy, the third course of chemotherapy, and the sixth course of chemotherapy) in order to determine serum levels of macro- and micronutrients (Na, Mg, Ca, Zn, P, Cu, Fe, Cd, Ni, and Sr). (3) Results: In the study group of patients with cancer of the reproductive tract, the concentrations of iron (<0.001), magnesium (0.038), sodium (0.014), and nickel (0.037) varied significantly over the course of the study. The analysis showed that the interaction between the stage of chemotherapy and the type of cancer had an effect on the concentrations of magnesium and cadmium (p < 0.05). (4) Conclusions: In the studied group of patients with ovarian and endometrial cancer, the applied chemotherapy significantly changed the concentrations of Fe, Na, and Ni, regardless of the type of tumor. Changes in Mg and Cd concentrations resulted from the interaction between the stage of chemotherapy and the type of cancer. The results of serum concentrations of selected elements in women with cancer of the reproductive organs may help understand the physiological changes resulting from the applied chemotherapy.

A Cross-Sectional Study of Sialic Acids Level in Breast Cancer Patients Attending Ahmadu Bello University Teaching Hospital Zaria, North-Western Nigeria: Preliminary investigations and Implications on Disease Subtypes, Grade and Chemotherapy Courses

Abstract Due to the challenges associated with breast cancer prognosis, this study examined sialic acid levels based on subtypes, grades and therapeutic courses among breast cancer patients presenting at Ahmadu Bello University Teaching Hospital (ABUTH) in North-Western Nigeria between June 2019 and December 2020. This was a cross-sectional study. Sociodemographic characteristics, total sialic acid (TSA), free sialic acid (FSA), bound sialic acid (BSA) and haematological parameters were determined. The mean age of the respondents was 47.46 ± 10.71 years, and the modal age range was 41-50 years. About 40% of the patients had triple-negative breast cancer subtype, and 83.1% had invasive carcinoma. There was an association between breast cancer grade and body mass index (χ2= 26.306, P= 0.001). The TSA, FSA and BSA concentrations were significantly (P&lt;0.05) higher in luminal A and triple-negative breast cancer patients when compared to apparently healthy controls and were highest in stage IV patients. The TSA correlated with the third and sixth chemotherapy courses. Significant (P&lt;0.05) decrease was observed in PCV and Hb among the breast cancer patients irrespective of subtype compared to healthy control. The results suggest that TSA, FSA and BSA were higher in breast cancer patients, necessitating further research on their possible prognostic implications.

The Quest for an Ideal Culinary Hyperlocalism

The Quest for an Ideal Culinary Hyperlocalism

Updates and Diagnostic Challenges in Surgical Pathology and Cytopathology.

Updates and Diagnostic Challenges in Surgical Pathology and Cytopathology.

Trastuzumab-emtansine induced pleural and pericardial effusions

Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate which combine trastuzumab (T), a monoclonal antibody targeting the human epidermal growth factor receptor-2 (HER2), and a cytotoxic molecule derived from maytansine (DM1). We report the first case of T-DM1-associated pleural and pericardial effusions three weeks after the second course of T-DM1 in a patient with breast cancer. Drug-induced pleural and pericardial effusions was implicated in the absence of other etiologies. The Naranjo Scale indicated a probable drug-induced adverse reaction.Management & outcome: The patient fully recovered after thoracentesis and discontinuation of T-DM1. The patient has reported no side effect after the sixth course of trastuzumab. To our knowledge, this is the first case in the literature of bilateral pleural and pericardial effusions in a patient treated with T-DM1. The successful initiation of treatment with trastuzumab following withdrawal of T-DM1 suggests that emtansine played a role in the development of bilateral pleural and pericardial effusions. We hypothesize that the patient's condition was a result of a local inflammatory reaction to emtansine by direct toxicity.

Longitudinal Dynamics of Coagulation and Angiogenesis Markers in Cancer Patients During and After Chemotherapy.

Hemostatic parameters have been investigated as molecular determinants of tumor progression. To analyze the dynamics of microparticle-associated tissue factor activity (MPTF), tissue factor antigen (TF-Ag), and angiopоietin-2 (ANG-2) in cancer patients before, during, and after active treatment and to explore their potential as biomarkers for metastatic occurrence and death. Blood for the analysis of MPTF, TF-Ag, ANG-2, and conventional hemostatic tests was sampled in 111 patients with various cancers at 4 consecutive visits: before first chemotherapy cycle, after 3 courses, at the sixth course, and 3 months after chemotherapy cessation. Patients were followed up until metastatic progression/death or the end of the study. MPTF did not change during chemotherapy, but increased significantly after treatment cessation. Total TF-Ag and ANG-2 decreased throughout active treatment. Significant drop of their levels was observed 3 months post therapy cessation. Progressive disease was significantly associated with higher pre-chemotherapy TF-Ag and fibrinogen. Elevated baseline levels of fibrinogen were associated with increased risk of shortened progression free survival. Cessation of chemotherapy is associated with significant change of hemostatic parameters. Pre-chemotherapy levels of TF-Ag and fibrinogen may be informative of disease state and prognosis.

Improved Outcomes with Induction Chemotherapy Combined with Arsenic Trioxide in Stage 4 Neuroblastoma: A Case Series

Objective: The apoptotic and cytotoxic effects of arsenic trioxide (ATO) makes it a potentially suitable agent for the treatment of patients with neuroblastoma with poor prognosis; therefore, we try to evaluate the effectiveness and safety of ATO combined with reinduction/induction chemotherapy in children with recurrent/refractory or newly diagnosed stage 4 neuroblastoma. Methods: Retrospective analysis was performed on seven pediatric patients with recurrent /refractory or newly diagnosed stage 4 neuroblastoma treated with traditional reinduction/induction chemotherapy combined with ATO. Results: A total of 7 patients were treated synchronously with ATO and chemotherapy for up to nine courses; all patients received conventional chemotherapy plus a 0.16 mg/kg/day dose of intravenous ATO during reinduction/induction chemotherapy. Treatment was effective in five patients and ineffective in the other two patients. The overall response rate was 71.43% (5 of 7). The side effects of the ATO combination were minor, whereby only treatment in one patient was terminated at the sixth course due to a prolonged QT interval (0.51 s), which returned to normal after symptomatic treatment. Conclusions: ATO can be safely and effectively combined with chemotherapy drugs as a potential alternative means of treatment for high-risk stage 4 neuroblastoma, and we have observed that ATO can restore the sensitivity of chemotherapy in some patients who were resistant to previous chemotherapy. Further investigations and clinical data are required to confirm these observations.

The Effectiveness of Aesthetic Teaching on the Attitude of Elementary School Students

The aim of this study was to investigate the effect of aesthetics based teaching on students' attitudes toward school. This is an all-experimental study of pre-test-post-test design with a control group. The statistical population of sixth grade students in schools Fardis in the academic year of 1997-98 was. The sampling method was simple random and the selected students were divided into experimental and control groups. The sample size was determined using Morgan table and the number of sample people in each group was 16. Experimental science course was taught in the experimental group by aesthetic teaching method and in the control group by traditional teaching method. To assess the attitude towards school, McCoach (2003) school attitude questionnaire (SAAS-R) was used with a reliability of 0.96. The obtained data were analyzed by multivariate analysis of covariance. The results showed that the level of attitude towards school in students who took the sixth grade experimental sciences course with aesthetic methods was different from the students who learned this course with the usual teaching methods in schools. Therefore, the aesthetic method can play a role as an active and effective method in students' academic achievement in science.

Efecto del entrenamiento en ábaco mental sobre la flexibilidad cognitiva: un estudio exploratorio

Mental Abacus (MA) training teaches students to solve math problems by visualizing a physical abacus structure to perform arithmetic operations. Research shows that MA practice relates with enhanced working memory in children, but other cognitive processes that could mediate the benefits registered remain unknown. The aim of the study was to analyze the effect of MA training in a cognitive flexibility task in twelve-year-old children, and compare it with a control group. 121 children from the sixth course of primary education were recruited. 54 students received MA training added during the academic year, while the control group received normative arithmetic instruction. MA training was provided by UCMAS Mental Arithmetic Spain S.L. To assess cognitive flexibility, we used the Trail Making Test (TMT). Data analysis entailed parametric assumptions check and a one-way ANOVA between MA and control group. There were no differences between groups in age. There were statistical differences in TMT-A (Z=-5,78, p&lt;,001, d=,67) and TMT-B scores (Z=-2,24, p=,021, d=,08). Our data suggest that MA enhances cognitive flexibility in children. MA is a promising tool teaching math which benefits go beyond arithmetic calculation.

NIMG-06. GUILLAIN BARRE MIMICKING LEPTOMENINGEAL SPREAD IN CANCER PATIENTS: REPORT OF TWO CASES AN REVIEW OF LITERATURE

Abstract BACKGROUND Guillain-Barre syndrome (GBS) is an immune acute polyradiculoneuropathy usually presented as an ascending peripheral paresis with absent tendon reflex and albumino-cytologic dissociation on cerebrospinal fluid (CSF) exam.We describe two oncologic patients with GBS who presented with atypical symptoms. RESULTS The first patient was a 35 years old woman with newly diagnosed grade 3 invasive breast ductal carcinoma. During the sixth courses of neo-adjuvant chemotherapy she complained at back pain and within 24 hours developed progressive severe bilateral proximal paraparesis with a D10 sensory level. Spine MRI demonstrated diffuse leptomeningeal enhancement. Since leptomeningeal spread (LMD) is uncommon at this stage of breast cancer CSF was obtained. CSF sample revealed albumin-cytologic dissociation (4 cells, protein level 340 mg/dl). EMG showed acute demyelinating neuropathy consistent with GBS. Intravenous immunoglobulins (IVIG) therapy was initiated with clinical improvement. The second patient was a 45 years old woman with newly diagnosed T-Cell lymphoma. Before initiating chemotherapy she presented with a rapidly progressive tetraparesis, hyperreflexia and cervical sensory level. Spine MRI was intact. CSF showed 22 cells without atypia, FACS negative, protein level was 74 mg/dl. The patient worsened clinically. A second CSF sample was obtained and demonstrated an albumin-cytologic dissociation (8 cells without atypia, protein level 115 mg/dl) raising the possibility of GBS. EMG showed acute axonal polyneuropathy consistent with AMSAN variant of GBS. The patient was treated with IVIG with partial recovery. CONCLUSION Atypical presentation of GBS could be challenging among oncologic patients and could lead to misdiagnosis and delay in treatment.

Protective effect of the oral administration of cystine and theanine on oxaliplatin-induced peripheral neuropathy: a pilot randomized trial

BackgroundOxaliplatin, one of the key cytotoxic drugs for colorectal cancer, frequently causes peripheral neuropathy which leads to dose modification and decreased patients’ quality of life. However, prophylactic or therapeutic measures have not yet been established. Orally administered amino acids, cystine and theanine, promoted the synthesis of glutathione which was one of the potential candidates for preventing the neuropathy. The aim of this study was to determine whether daily oral administration of cystine and theanine attenuated oxaliplatin-induced peripheral neuropathy (OXLIPN).MethodsTwenty-eight colorectal cancer patients who received infusional 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) therapy were randomly and evenly assigned to the cystine and theanine group and the control group. OXLIPN was assessed up to the sixth course using original 7-item questionnaire as well as Common Terminology Criteria for Adverse Events (CTCAE) grading scale.ResultsNeuropathy scores according to our original questionnaire were significantly smaller in the cystine and theanine group at the fourth (p = 0.026), fifth (p = 0.029), and sixth course (p = 0.038). Furthermore, significant differences were also observed in CTCAE neuropathy grades at the fourth (p = 0.037) and the sixth course (p = 0.017). There was one patient in each group who required dose reduction due to OXLIPN. Except for neurotoxicity, no significant differences were noted in the incidence of adverse events, and the total amount of administered oxaliplatin.ConclusionThe results demonstrated the daily oral administration of cystine and theanine attenuated OXLIPN.