A review of relative dose intensity and survival in patients with metastatic solid tumors

Havrilesky, Laura J.; Reiner, Maureen; Morrow, Phuong Khanh; Watson, Holly Howe; Crawford, Jeffrey

doi:10.1016/j.critrevonc.2014.10.006

Cited by 102 publications

(106 citation statements)

References 19 publications

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“…dose of chemotherapy delivered per unit of time) and dose density (i.e. time of intervals between dose administration of chemotherapy), which may be important determinants for the effects of systemic treatment on survival . Low muscle mass may be related to excess toxicities due to an increased fragility or a pharmacokinetic effect .…”

Section: Introductionmentioning

confidence: 99%

Skeletal muscle mass loss and dose‐limiting toxicities in metastatic colorectal cancer patients

Kurk

Peeters

Stellato

et al. 2019

J cachexia sarcopenia muscle

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Background Increasing evidence suggests that severe skeletal muscle index (SMI) loss (sarcopenia) is associated with poor overall survival in metastatic colorectal cancer patients, but its mechanisms are unknown. We recently found, using data of the randomized phase 3 CAIRO3 study, that SMI loss was related with shorter time to disease progression and overall survival during first‐line maintenance treatment with capecitabine + bevacizumab (CAP‐B) or observation and during more intensive capecitabine + oxaliplatin + bevacizumab (CAPOX‐B) reintroduction treatment. As a potential risk factor for reduced survival, we explored whether sarcopenia and SMI loss were associated with dose‐limiting toxicities (DLTs) during CAP‐B and CAPOX‐B. Methods Sarcopenia status and SMI loss were assessed by using consecutive computed tomography scans. DLTs were defined as any dose delay/reduction/discontinuation of systemic treatment because of reported CTCAE (version 3.0) toxicities at the start or during treatment. Poisson regression models were used to study whether sarcopenia and body mass index (BMI) at the start of treatment and SMI and BMI loss during treatment were associated with DLTs. Results One hundred eighty‐two patients (mean age 63.0 ± 8.8 years, 37% female) received CAP‐B, and 232 patients (mean age 63.0 ± 9.0 years, 34% female) received CAPOX‐B. At the start of CAP‐B and CAPOX‐B, 54% and 46% of patients were sarcopenic, respectively. Mean BMI was lower in sarcopenic patients, although patients were on average still overweight (sarcopenic vs. non‐sarcopenic at the start of CAP‐B 25.0 ± 3.9 vs. 26.7 ± 4.1 and CAPOX‐B 25.8 ± 3.8 vs. 27.1 ± 3.8 kg/m 2 ). Sarcopenia at the start of CAP‐B was not associated with DLTs [relative risk 0.87 (95% confidence interval 0.64–1.19)], whereas patients with >2% SMI loss had a significantly higher risk of DLTs [1.29 (1.01–1.66)]. At the start of subsequent CAPOX‐B, 25% of patients received a dose reduction, and the risk of dose reduction was significantly higher for patients with preceding SMI loss [1.78 (1.06–3.01)] or sarcopenia [1.75 (1.08–2.86)]. After the received dose reductions, sarcopenia or SMI loss was not significantly associated with a higher risk of DLTs during CAPOX‐B [sarcopenia vs. non‐sarcopenic: 0.86 (0.69–1.08) and SMI loss vs. stable/gain: 0.83 (0.65–1.07)]. In contrast, BMI (loss) at the start or during either treatment was not associated with an increased risk of DLTs. Conclusions In this large longitudinal study in metastatic colorectal cancer patients during palliative systemic treatment, sarcopenia and/or muscle loss was associated with an increased risk of DLTs. BMI was not associated with DLTs and could not detect sarcopenia or SMI loss. Prospective (randomized) studies should reveal whether normalizing chemotherapeutic doses to muscle mass or muscle mass preservation (by exercise and nutritional interventions)...

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Section: Introductionmentioning

confidence: 99%

Skeletal muscle mass loss and dose‐limiting toxicities in metastatic colorectal cancer patients

Kurk

Peeters

Stellato

et al. 2019

J cachexia sarcopenia muscle

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“…CIPN can cause treatment dose-reductions and discontinuation, leading to poor tumor control and worse prognosis [3–5]. Approximately 50% of breast cancer patients receive taxane therapy, including paclitaxel and docetaxel, as a large clinical trial has shown that adjuvant paclitaxel could effectively improve overall survival for women with node positive and high-risk node negative breast cancer [6–8].…”

Section: Introductionmentioning

confidence: 99%

Randomized sham-controlled pilot trial of weekly electro-acupuncture for the prevention of taxane-induced peripheral neuropathy in women with early stage breast cancer

Greenlee

Crew

Capodice

et al. 2016

Breast Cancer Res Treat

139

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PURPOSE To investigate the effect of electro-acupuncture (EA) as a non-pharmacological intervention to prevent or reduce chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients undergoing chemotherapy of taxane. METHODS Women with stage I-III breast cancer scheduled to receive taxane therapy were randomized to receive a standardized protocol of 12 true or sham EA (SEA) weekly treatments concurrent with taxane treatment. Subjects completed the Brief Pain Inventory-Short Form (BPI-SF), Functional Assessment of Cancer Therapy-Taxane neurotoxicity subscale (FACT-NTX), and other assessments at baseline and weeks 6, 12, and 16. RESULTS A total of 180 subjects were screened, 63 enrolled and 48 completed week 16 assessments. Mean age was 50 with 25% white, 25% black, and 43% Hispanic; 52% had no prior chemotherapy. At week 12, both groups reported an increase in mean BPI-SF worst pain score, but no mean differences were found between groups (SEA 2.8 vs. EA 2.6, p=.86). By week 16, the SEA group returned to baseline, while the EA group continued to worsen (mean=1.7 in SEA vs. 3.40 in EA, p=.03). The increase in BPI-SF worst pain score was 1.62 points higher in the EA group than in the SEA group at week 16 (p=.04). CONCLUSIONS In a randomized, sham-controlled trial of EA for prevention of taxane-induced CIPN, there were no differences in pain or neuropathy between groups at week 12. Of concern, subjects on EA had a slower recovery than SEA subjects. Future studies should focus on EA for treatment as opposed to prevention of CIPN.

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“…The mechanisms are usually attributed to microtubule disruption (taxanes, vinca alkaloids) or a direct toxic effect (platinums) [7]. In some cases, symptoms are severe enough to require chemotherapy dose reductions [6-8], resulting in reduced chemotherapeutic benefit for patients [9, 10]. In other cases, symptoms decrease QoL by affecting mobility and limiting ability to perform simple daily activities [7, 11].…”

Section: Introductionmentioning

confidence: 99%

Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: A systematic review

Brami

Bao

Deng

2016

Critical Reviews in Oncology/Hematology

119

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Chemotherapy-induced peripheral neuropathy (CIPN) is a serious dose-limiting side-effect without any FDA-approved treatment option. Prior reviews focus mostly on pharmacological interventions, but nonpharmaceutical interventions have also been evaluated. A Web of Science and PubMed database search to identify relevant RCTs from January 2005 to May 2015 included the terms: CIPN, cancer; and supplements, vitamin E, goshajinkigan, kampo, acetyl-L-carnitine, carnitine, alpha-lipoic acid, omega-3, glutamine, or glutamate; or massage, acupuncture, mind-body practice, yoga, meditation, Tai-Chi, physical activity, or exercise. Of 1465 publications screened, 12 RCTs evaluated natural products and one evaluated electroacupuncture. Vitamin E may help prevent CIPN. L-glutamine, goshajinkigan, and omega-3 are also promising. Acetyl-L-carnitine may worsen CIPN and alpha-lipoic acid activity is unknown. Electroacupuncture was not superior to placebo. No RCTs were published regarding other complementary therapies, although some studies mention positive incidental findings. Natural products and complementary therapies deserve further investigation, given the lack of effective CIPN interventions.

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A review of relative dose intensity and survival in patients with metastatic solid tumors

Cited by 102 publications

References 19 publications

Skeletal muscle mass loss and dose‐limiting toxicities in metastatic colorectal cancer patients

Skeletal muscle mass loss and dose‐limiting toxicities in metastatic colorectal cancer patients

Randomized sham-controlled pilot trial of weekly electro-acupuncture for the prevention of taxane-induced peripheral neuropathy in women with early stage breast cancer

Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: A systematic review

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