Balancing oxaliplatin dose with neurological side effects in metastatic colon cancer
The drug oxaliplatin is a major reason the prognosis for metastatic colon cancer has gone from an expected survival of several months to a couple years. Unfortunately, the drug can also carry with it debilitating neurological side effects, which generally start as the sensation of pins and needles in fingers and toes and can leave patients unable to walk or dress independently.
However, "Many patients don't receive the necessary dose to try to keep their cancer in check, because their symptoms become too debilitating and their quality of life is reduced," says Andrew Weickhardt, MD, clinical fellow at the University of Colorado Cancer Center.
Weickhardt, along with Keith Wells, MD, and Wells Messersmith, MD, CU Cancer Center investigator and developmental therapeutics program co-leader, recently published a review in the Journal of Oncology that describes how to maximize the positives of this tricky balance between oxaliplatin's effects and side effects.
"Before, when patients died in a few months, these symptoms were overlooked. Now they're living two to three years and the symptoms deserve closer attention," Weickhardt says.
The review recommends two approaches, used alone or simultaneously what Weickhardt calls a "stop and go" approach, along with supplements that may mitigate the drug's neurological damage.
In the stop and go approach, a patient starts oxaliplatin along with another drug and takes both for two months. Then, the patient takes a hiatus from oxaliplatin (while continuing the first drug), and reintroduces oxaliplatin two months later or at the point of disease progression, whichever is sooner.
"After about six to nine months of total treatment, metastatic colorectal cancers tend to develop resistance to the drug," says Weickhardt. "And also, no matter what we do, after this same six to nine months of total treatment, neurological side effects start to rise." And so stop-and-go oxaliplatin dosing spreads the drug's effectiveness over the maximum possible time, with the fewest possible side effects.
Still, with this regimen, Weickhardt says that one in twenty patients experience significant nerve damage that can last for more than six months. "There's room for improvement," he says.
Though to date clinical trials of protective drugs given with oxaliplatin have been small, Weickhardt sees promise in the use of simple calcium and magnesium supplements.
"An infusion of calcium and magnesium should be used as well because they've shown some benefit and they don't do any harm," Weickhardt says. "They're popular in the community, and I'd encourage their use."
Provided by University of Colorado Denver
- Study shows that administering calcium and magnesium effectively reduces neurological sensitivity May 16, 2008 | not rated yet | 0
- Popular colorectal cancer drug may cause permanent nerve damage Sep 28, 2011 | not rated yet | 0
- Researchers discover genes affecting cancer drug Jan 13, 2011 | not rated yet | 0
- A safe, well-tolerated, and effective treatment for metastatic esophageal cancer Feb 23, 2009 | not rated yet | 0
- Study showed oxaliplatin improved colon cancer patient survival Jan 20, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer 23 hours ago | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer 23 hours ago | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer May 24, 2013 | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer May 24, 2013 | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer May 24, 2013 | 5 / 5 (4) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
4 hours ago | 5 / 5 (1) | 4
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
23 hours ago | 3.7 / 5 (3) | 4 |
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
4 hours ago | not rated yet | 1
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
20 hours ago | 3 / 5 (2) | 0 |
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
23 hours ago | 5 / 5 (5) | 0 |
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
4 hours ago | not rated yet | 0