Predictors of Hand-Foot Syndrome and Pyridoxine for Prevention of Capecitabine–Induced Hand-Foot Syndrome

Yap, Yoon Sim; Kwok, Li-Lian; Syn, Nicholas; Chay, Wen Yee; Chia, John Whay Kuang; Tham, Chee Kian; Wong, Nan Soon; Lo, Soo Kien; Dent, Rebecca; Tan, Shan; Mok, Zuan Yu; Koh, King Xin; Toh, Han Chong; Koo, Wen Hsin; Loh, Marie; Ng, Raymond; Choo, Su Pin; Soong, Richie

doi:10.1001/jamaoncol.2017.1269

Cited by 70 publications

(61 citation statements)

References 37 publications

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“…Of the eligible studies, 12 were RCTs, [9][10][11][12]18,[20][21][22][23][24][25][26] and five were cohort studies. A total of 2081 patients (mean sample size: 122; median sample size with corresponding range: 106 ) were included in this meta-analysis.…”

Section: What's New?mentioning

confidence: 99%

“…A total of 2081 patients (mean sample size: 122; median sample size with corresponding range: 106 ) were included in this meta-analysis. 11,27 The following prevention strategies were addressed in the analyzed studies: pyridoxine (10 studies) 8,11,12,[19][20][21][22]24,26,27 ; topical urea/ lactic acid (three studies) 8,10,25 ; celecoxib (two studies) 9,28 ; and moisturizing cream, topical silymarin, Fuzheng Jiedusan and neurotropin (four studies). 8,17,19,27,28 Fifteen studies only assessed the prophylactic efficacies of prevention strategies, [8][9][10][11][12][17][18][19][20][21][22][23][24][25][26][27][28] and two studies assessed prophylactic and treatment efficacies.…”

Section: What's New?mentioning

confidence: 99%

“…Among these, hand-foot syndrome (HFS) is the most common adverse event of capecitabine-containing chemotherapy. 4,6,7 Several clinical trials have evaluated different drugs, including pyridoxine, topical urea/lactic acid and a cyclooxygenase-2 (COX-2) inhibitor, for the management of capecitabineinduced HFS [8][9][10][11][12] ; however, the efficacies of prevention and treatment strategies remain controversial. 3,4 The severity of HFS symptoms depends on the drug dose, peak concentration and total cumulative dose.…”

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confidence: 99%

“…5 Therefore, HFS can lead to the cessation of therapy or a dose reduction and adversely affects quality of life and treatment efficacy, although HFS is usually not life-threatening. 4,6,7 Several clinical trials have evaluated different drugs, including pyridoxine, topical urea/lactic acid and a cyclooxygenase-2 (COX-2) inhibitor, for the management of capecitabineinduced HFS [8][9][10][11][12] ; however, the efficacies of prevention and treatment strategies remain controversial.The purpose of this study was to assess the efficacies of prevention and treatment strategies for capecitabine-induced HFS and report the incidence of capecitabine-induced HFS.…”

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Clinical evidence of prevention strategies for capecitabine‐induced hand‐foot syndrome

Huang

Chen

et al. 2018

Intl Journal of Cancer

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Hand-foot syndrome (HFS) is the most common adverse effect of capecitabine-containing chemotherapy. The purpose of this study was to assess the efficacies of various prevention and treatment strategies for capecitabine-induced HFS. Searches of the PubMed and Embase databases were performed to identify relevant studies. The risk ratio (RR) with the corresponding 95% confidence interval (CI) was used as an effect measure to evaluate the efficacies of these prevention and treatment strategies. Publication bias was evaluated using Begg's and Egger's tests. Overall and subgroup analyses were conducted. All statistical analyses were conducted with Stata software version 12.0. Seventeen eligible studies were included. Our results indicated that celecoxib was significantly associated with a lower incidence of grade ≥2 capecitabine-induced HFS without heterogeneity (RR = 0.43, 95% CI = 0.23-0.81, I = 0.0%). However, pyridoxine and topical urea/lactic acid were not effective toward preventing capecitabine-induced grade 1, 2, 3, ≥1 or ≥2 HFS. Moreover, pyridoxine was not effective in treating capecitabine-induced HFS. Similar results were obtained by subgroup analysis. Our results indicate that celecoxib has potential prophylactic efficacy for capecitabine-induced HFS. However, pyridoxine and topical urea/lactic acid are not associated with a decrease in the incidence of capecitabine-induced HFS.

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Section: What's New?mentioning

confidence: 99%

Section: What's New?mentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical evidence of prevention strategies for capecitabine‐induced hand‐foot syndrome

Huang

Chen

et al. 2018

Intl Journal of Cancer

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“…Pyridoxine (vitamin B6 [VB6]) is a common drug for relieving HFS. However, no clinical evidence was found to support the use of VB6 supplements to prevent HFS during chemotherapy, and VB6 did not show efficacy in randomized controlled clinical studies (Jo, Shin, Jo, Kwon, & Myung, ; Yap et al, ). Currently, the most effective approach for managing HFS is to interrupt or decrease the dose of chemotherapy until symptoms improve (Degen et al, ; Miller et al, ).…”

Section: Introductionmentioning

confidence: 99%

Herbal medicine for hand–foot syndrome induced by fluoropyrimidines: A systematic review and meta‐analysis

Deng

Sun

2018

Phytotherapy Research

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The aims of this study were to evaluate the efficacy of herbal medicine for the prevention and management of hand-foot syndrome (HFS) induced by fluoropyrimidines and to identify herbs associated with HFS alleviation for further research. The PubMed, Cochrane, Springer, China National Knowledge Infrastructure, and Wanfang databases were searched up to May 2017 for randomized controlled trials (RCTs) that evaluated herbal medicine for relieving HFS in patients undergoing fluoropyrimidine-based chemotherapy. Study evaluation and synthesis methods were in accordance with the Cochrane Handbook, and data were analyzed using RevMan 5.3. In total, 35 RCTs (2,668 participants) were included. Meta-analysis showed that the addition of herbal medicine significantly reduced the incidences of all-grade and high-grade HFS. The total effective rate and complete remission rate of HFS patients increased significantly with herbal medicine arm. Further sensitivity analysis identified Paeoniae Radix Alba, Carthami Flos, Cinnamomi Ramulus, and Glycyrrhizae Radix et Rhizoma as being consistently associated with significant reductions in HFS incidence without important heterogeneity. However, the lack of blinding in most studies may have led to overestimation of these effects. More high-quality RCTs and experimental research are needed to confirm and investigate the efficacy of the herbs identified in this study.

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Insights Into Breast Cancer in the East vs the West

Yap

Takagi³

et al. 2019

JAMA Oncol

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105

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IMPORTANCEDuring the past few decades, the incidence of breast cancer (BC) has been increasing rapidly in East Asia, and BC is currently the most common cancer in several countries. The rising incidence is likely related to changing lifestyle and environmental factors in addition to the increase in early diagnosis with BC awareness and screening. The understanding and management of BC are generally based on research and data from the West. However, emerging differences in BC epidemiology and tumor and host biology in Asian populations may be clinically relevant.OBSERVATIONS A higher proportion of premenopausal BCs occur in Asia, although this factor is possibly an age-cohort effect. Although the relative frequencies of different immunohistochemical subtypes of BC may be similar between the East and West, the higher prevalence of luminal B subtypes with more frequent mutations in TP53 may be confounded by disparities in early detection. In addition, Asian BCs appear to harbor a more immune-active microenvironment than BCs in the West. The spectra of germline mutations in BC predisposition genes and single-nucleotide polymorphisms contributing to BC risk vary with ethnicity as well. Differences in tolerability of certain cytotoxic and targeted agents used in BC treatment may be associated with pharmacogenomic factors, whereas the lower body mass of the average woman in East Asia may contribute to higher toxicities from drugs administered at fixed doses. Phenotypic characteristics, such as lower breast volume, may influence the type of surgery performed in East Asian women. On the other hand, increased breast density may affect the sensitivity of mammography in detecting BCs, limiting the benefits of screening mammography. CONCLUSIONS AND RELEVANCEBreast cancer has become a major health problem in Asia. The inclusion of more women from Asia in clinical trials and epidemiologic and translational studies may help unravel the interethnic heterogeneity of BCs and elucidate the complex interplay between environmental and intrinsic factors in its pathogenesis. These insights may help to refine prevention, diagnosis, and management strategies for BC in the setting of ethnic diversity.

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Predictors of Hand-Foot Syndrome and Pyridoxine for Prevention of Capecitabine–Induced Hand-Foot Syndrome

Abstract: clinicaltrials.gov Identifier: NCT00486213.

Cited by 70 publications

References 37 publications

Clinical evidence of prevention strategies for capecitabine‐induced hand‐foot syndrome

Clinical evidence of prevention strategies for capecitabine‐induced hand‐foot syndrome

Herbal medicine for hand–foot syndrome induced by fluoropyrimidines: A systematic review and meta‐analysis

Insights Into Breast Cancer in the East vs the West

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