Frequency, Characteristics, and Reversibility of Peripheral Neuropathy During Treatment of Advanced Multiple Myeloma With Bortezomib
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Published:2006-07-01
Issue:19
Volume:24
Page:3113-3120
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ISSN:0732-183X
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Container-title:Journal of Clinical Oncology
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language:en
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Short-container-title:JCO
Author:
Richardson Paul G.1, Briemberg Hannah1, Jagannath Sundar1, Wen Patrick Y.1, Barlogie Bart1, Berenson James1, Singhal Seema1, Siegel David S.1, Irwin David1, Schuster Michael1, Srkalovic Gordan1, Alexanian Raymond1, Rajkumar S. Vincent1, Limentani Steven1, Alsina Melissa1, Orlowski Robert Z.1, Najarian Kevin1, Esseltine Dixie1, Anderson Kenneth C.1, Amato Anthony A.1
Affiliation:
1. From the Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston; Millennium Pharmaceuticals Inc, Cambridge, MA; St Vincent’s Cancer Center; York Presbyterian Hospital, New York, NY; University of Arkansas, Little Rock, AR; Institute for Myeloma and Bone Cancer Research, West Hollywood; Alta Bates Cancer Center, Berkley, CA; Robert H. Lurie Cancer Center, Chicago, IL; Hackensack University Medical Center, Hackensack, NJ; New Sparrow Regional Cancer Center, Lansing, MI; M.D. Anderson Cancer...
Abstract
PurposeTo determine the frequency, characteristics, and reversibility of peripheral neuropathy from bortezomib treatment of advanced multiple myeloma.Patients and MethodsPeripheral neuropathy was assessed in two phase II studies in 256 patients with relapsed and/or refractory myeloma treated with bortezomib 1.0 or 1.3 mg/m2intravenous bolus on days 1, 4, 8, and 11, every 21 days, for up to eight cycles. Peripheral neuropathy was evaluated at baseline, during the study, and after the study by patient-reported symptoms using the Functional Assessment of Cancer Therapy Scale/Gynecologic Oncology Group–Neurotoxicity (FACT/GOG-Ntx) questionnaire and neurologic examination. During the study, peripheral neuropathy was also evaluated by investigator assessment. A subset of patients underwent nerve conduction studies (n = 13).ResultsBefore treatment, 194 (81%) of 239 patients had peripheral neuropathy by FACT/GOG-Ntx questionnaire, and 203 (83%) of 244 patients had peripheral neuropathy by neurologic examination. Treatment-emergent neuropathy was reported in 35% of patients, including 37% (84 of 228 patients) receiving bortezomib 1.3 mg/m2and 21% (six of 28 patients) receiving bortezomib 1.0 mg/m2. Grade 1 or 2, 3, and 4 neuropathy occurred in 22%, 13%, and 0.4% of patients, respectively. The incidence of grade ≥ 3 neuropathy was higher among patients with baseline neuropathy by FACT/GOG-Ntx questionnaire compared with patients without baseline neuropathy (14% v 4%, respectively). In all 256 patients, neuropathy led to dose reduction in 12% and discontinuation in 5%. Of 35 patients with neuropathy ≥ grade 3 and/or requiring discontinuation, resolution to baseline or improvement occurred in 71%.ConclusionBortezomib-associated peripheral neuropathy seemed reversible in the majority of patients after dose reduction or discontinuation. Although severe neuropathy was more frequent in the presence of baseline neuropathy, the overall occurrence was independent of baseline neuropathy or type of prior therapy.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Cited by
552 articles.
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