quid,
As tuck has posted, neuropathy is primarily a problem for the platinum drugs. Oxaliplatin isn't really gold standard for colorectal, but it's newly approved for first line treatment and works a little better than some (which is to say pretty badly).
Now the neuropathy from oxaliplatin is somewhat different in character from that caused by the other platinum drugs, so we can't just assume that the same problem will occur across the board with platinum drugs.
Here are the details of oxaliplatin sensory neuropathy:
Peripheral sensory neuropathy is cumulative, dose-related and usually reversible a few months after stopping treatment. Symptoms include sensory ataxia and dysesthesia of the limbs, mouth, throat and larynx, and may be exacerbated by exposure to cold (eg, touching cold surface, drinking cold liquid).1,28 The incidence of grade 2 neuropathy is 10% after 3 treatment cycles and 50% after 10 cycles. Grade 3 neuropathy occurs in 10% after 9 cycles and 50% after 14 cycles, is reversible in 74% of the cases, and begins to recover after 13 weeks. Paresthesia interfering with function (eg, buttoning clothing, holding objects, writing) is seen in 16% of patients after 4 months of treatment and rarely leads to oxaliplatin withdrawal.11 Unlike cisplatin, oxaliplatin neuropathy is related to injury to small rather than large sensory fibres.
Peter |
