Clinical assessment of chemotherapy-induced peripheral neuropathy: a discrete choice experiment of patient preferences

Yu, Alice; Street, Deborah J.; Viney, Rosalie; Goodall, Stephen; Pearce, Alison; Haywood, Philip; Haas, Marion; Battaglini, Eva; Goldstein, David; Timmins, Hannah C.; Park, Susanna B.

doi:10.1007/s00520-021-06196-8

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…Missing data in some demographic and clinical characteristics (i.e., age, BMI, and cancer stages) were due to the participants failing to respond to the questionnaire, incomplete medical records, and safety reasons, and may lead to biased results. Finally, there is currently no gold standard assessment tool for CIPN [ 44 ]. The present study employed the CIPN20 patient self-reported questionnaire to assess the participants’ experience of symptoms and functional limitations related to CIPN [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Physical function as a predictor of chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

Lin,

Chen,

Lin

2024

BMC Gastroenterol

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Background A growing body of research indicates that poor functional status before chemotherapy may be correlated with the severity of chemotherapy-induced peripheral neuropathy (CIPN) after the neurotoxic treatment. However, little is known about the associations between pre-chemotherapy physical function and CIPN in patients with pancreatic cancer. Purpose To identify the predictors of CIPN in relation to pre-chemotherapy physical function in patients with pancreatic cancer. Methods This secondary analysis included data from patients with pancreatic cancer who participated in a longitudinal research study at National Cheng Kung University Hospital, Tainan, Taiwan. Four physical function tests (i.e., grip strength, Timed Up and Go (TUG), 2-minute step test (2MST), and Romberg test) and two questionnaires (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 [EORTC QLQ-C30] and Chemotherapy-Induced Peripheral Neuropathy Module [CIPN20]) were assessed at baseline (i.e., before first chemotherapy session) and 2-, 3-, 4-, and 6-month follow-up. Multiple linear regression with adjustment for confounding factors was used to assess the associations between the four functional tests at baseline and the CIPN20 total score and individual subscale scores (sensory, motor, and autonomic) at 6-month follow-up. Results Data from a total of 209 pancreatic cancer patients (mean age: 64.4 years, 54.5% male) were analyzed. The findings showed that the severity of CIPN at 6-month follow-up was significantly associated with the baseline TUG completion time (β = 0.684, p = 0.003). The TUG completion time was also positively correlated with the 6-month CIPN sensory and autonomic subscales. In addition, a baseline positive Romberg test (β = 0.525, p = 0.009) was a significant predictor of the severity of motor neuropathy at 6-month follow-up. Conclusion The TUG completion time and positive Romberg test before chemotherapy may be predictive factors of the CIPN severity 6 months after the commencement of chemotherapy. Accordingly, the incorporation of TUG and Romberg tests into the clinical assessment protocol emerges as imperative for individuals diagnosed with pancreatic carcinoma undergoing chemotherapy regimens.

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Section: Discussionmentioning

confidence: 99%

Physical function as a predictor of chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

Lin,

Chen,

Lin

2024

BMC Gastroenterol

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“…Another critical feature for use in clinic is acceptability from the patient perspective. A study of patient preferences for CIPN assessment found that patients prefer a comprehensive CIPN assessment including a physical test [ 63 ]. There are a range of different approaches to CIPN assessment beyond PROMs, including clinician-graded assessment (NCI-CTCAE), functional assessment (e.g., balance and fine motor function) and clinical neurological examination.…”

Section: Discussionmentioning

confidence: 99%

Assessing chemotherapy-induced peripheral neuropathy with patient reported outcome measures: a systematic review of measurement properties and considerations for future use

Park

Battaglini

et al. 2022

Qual Life Res

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Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is a common toxicity of cancer treatment, with potential to significantly impact cancer survivors’ long-term quality of life. Patient reported outcome measures (PROMs) are increasingly utilised to evaluate CIPN. However, guidance remains lacking on how to identify fit for purpose PROMs with considerations necessarily differing when used in various research and in-clinic contexts. This study aimed to evaluate evidence about CIPN PROMs measurement properties and propose considerations to optimize CIPN PROM selection for each purpose. Methods A systematic review was conducted to identify literature assessing measurement properties of CIPN PROMs. These were evaluated against Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria and International Society for Quality of Life minimum standards. Risk of Bias (RoB) was assessed using the COSMIN RoB checklist. Results Thirty-nine papers evaluating measurement properties of 13 PROMs were included. The European Organization for Research and Treatment of Cancer Quality of Life Chemotherapy-Induced Peripheral Neuropathy Questionnaire (QLQ-CIPN20) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) were the most commonly investigated PROMs and had the most measurement properties meeting established criteria. Conclusion The use of the QLQ-CIPN20 and FACT/GOG-Ntx to assess CIPN in research settings has the most supporting evidence. However other considerations including study aims, endpoints and target population also factor into PROM selection and need to be considered more often when determining the most suitable outcome measure. Evidence of CIPN PROMs use in clinical practice is limited and their adoption to individual-patient level management requires more evaluation.

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“…Along this same line, a published research survey examining patient preferences for the design of a CIPN assessment tool in neurotoxic chemotherapy-treated patients with cancer revealed a preference for a 30 min addition to routine clinic time to accommodate a detailed, proactive CIPN assessment. Such an assessment would include objective and instrumental assessment tools that would favour shared decision-making processes with the treating team [ 116 ]. In summary, a combination of physician-based methods, varying PROM scales, and sufficient time to properly assess PN are needed to comprise the most reliable approach to measure BVIN through valid means [ 117 ].…”

Section: Early Diagnosis and Management Of Bvinmentioning

confidence: 99%

“…Patient preferences with regards to potential toxicities and treatments are important in relation to decision-making processes regarding treatment [ 116 ]. When BVIN occurs, patients and clinicians may face the dilemma by choosing whether to reduce chemotherapy or even stop it altogether to prevent a worsening pf PN.…”

Section: Early Diagnosis and Management Of Bvinmentioning

confidence: 99%

Brentuximab-Induced Peripheral Neurotoxicity: A Multidisciplinary Approach to Manage an Emerging Challenge in Hodgkin Lymphoma Therapy

Velasco

Domingo‐Domenech

Sureda

2021

Cancers

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Brentuximab vedotin (BV) is an anti-CD30 antibody–drug conjugate approved to treat classical Hodgkin lymphoma (HL). BV-induced peripheral neurotoxicity (BVIN) is one of the greatest concerns for haematologists treating HL for several reasons. First, BVIN is highly frequent. Most patients receiving BV will experience some degree of BVIN, resulting in the primary reason for dose modification or discontinuation of HL therapy. Second, BV produces sensory, motor, and/or autonomic peripheral nerve dysfunction, which can present as severe, disabling forms of BVIN—predominantly motor—in some patients. Third, although largely reversible, BVIN may persist months or years after treatment and thereby become a major issue in HL survivorship. BVIN may, therefore, negatively affect the quality of life and work-life of often young patients with HL, in whom long-term survival is expected. Currently, the only strategy for BVIN includes dose adjustments and treatment discontinuation; however, this could interfere with LH therapy efficacy. In this setting, early recognition and adequate management of BVIN are critical in improving clinical outcomes. Careful neurologic monitoring may allow accurate diagnoses and gradation of ongoing forms of BVIN presentation. This review analysed current, available data on epidemiology, pathophysiology, patient- and treatment-related risk factors, clinical and neurophysiologic phenotypes, and management in patients with HL. Furthermore, this review specifically addresses limitations posed by BVIN assessments in clinical practice and provides skills and tools to improve neurologic assessments in these patients. Integrating this neurotoxic drug in clinical practice requires a multidisciplinary approach to avoid or minimise neurotoxicity burden in survivors of HL.

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Clinical assessment of chemotherapy-induced peripheral neuropathy: a discrete choice experiment of patient preferences

Cited by 5 publications

References 24 publications

Physical function as a predictor of chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

Physical function as a predictor of chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

Assessing chemotherapy-induced peripheral neuropathy with patient reported outcome measures: a systematic review of measurement properties and considerations for future use

Brentuximab-Induced Peripheral Neurotoxicity: A Multidisciplinary Approach to Manage an Emerging Challenge in Hodgkin Lymphoma Therapy

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