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Phase III randomized, placebo‐controlled, double‐blind study of monosialotetrahexosylganglioside for the prevention of oxaliplatin‐induced peripheral neurotoxicity in stage II/III colorectal cancer.

Authors :
Wang, De‐shen
Wang, Zhi‐qiang
Chen, Gong
Peng, Jie‐wen
Wang, Wei
Deng, Yan‐hong
Wang, Feng‐hua
Zhang, Jian‐wei
Liang, Han‐lin
Feng, Fen
Xie, Chuan‐bo
Ren, Chao
Jin, Ying
Shi, Si‐mei
Fan, Wen‐hua
Lu, Zhen‐hai
Ding, Pei‐rong
Wang, Feng
Xu, Rui‐hua
Li, Yu‐hong
Source :
Cancer Medicine; Jan2020, Vol. 9 Issue 1, p151-159, 9p
Publication Year :
2020

Abstract

Background: Monosialotetrahexosylganglioside (GM1) is a neuroprotective glycosphingolipid that repairs nerves. Oxaliplatin‐based chemotherapy is neurotoxic. This study assessed the efficacy of GM1 for preventing oxaliplatin‐induced peripheral neurotoxicity (OIPN) in colorectal cancer (CRC) patients receiving oxaliplatin‐based chemotherapy. Methods: In total, 196 patients with stage II/III CRC undergoing adjuvant chemotherapy with mFOLFOX6 were randomly assigned to intravenous GM1 or a placebo. The primary endpoint was the rate of grade 2 or worse cumulative neurotoxicity (NCI‐CTCAE). The secondary endpoints were chronic cumulative neurotoxicity (EORTCQLQ‐CIPN20), time to grade 2 neurotoxicity (NCI‐CTCAE or the oxaliplatin‐specific neuropathy scale), acute neurotoxicity (analog scale), rates of dose reduction or withdrawal due to OIPN, 3‐year disease‐free survival (DFS) and adverse events. Results: There were no significant differences between the arms in the rate of NCI‐CTCAE grade 2 or worse neurotoxicity (GM1: 33.7% vs placebo: 31.6%; P =.76) or neuropathy measured by the EORTCQLQ‐CIPN20 or time to grade 2 neurotoxicity using NCI‐CTCAE and the oxaliplatin‐specific neuropathy scale. GM1 substantially decreased participant‐reported acute neurotoxicity (sensitivity to cold items [P <.01], discomfort swallowing cold liquids [P <.01], throat discomfort [P <.01], muscle cramps [P <.01]). The rates of dose reduction or withdrawal were not significantly different between the arms (P =.08). The 3‐year DFS rates were 85% and 83% in the GM1 and placebo arms, respectively (P =.19). There were no differences in toxicity between the arms. Conclusion: Patients receiving GM1 were less troubled by the symptoms of acute neuropathy. However, we do not support the use of GM1 to prevent cumulative neurotoxicity. (ClinicalTrials.gov number, NCT02251977). [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20457634
Volume :
9
Issue :
1
Database :
Complementary Index
Journal :
Cancer Medicine
Publication Type :
Academic Journal
Accession number :
141050645
Full Text :
https://doi.org/10.1002/cam4.2693