Info for PATRICIA LEN & anyone on Oxalyplatin

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Hi

Have read this on another board, apologies if has already appeared on this

board.

Prevention of oxaliplatin-related neurotoxicity by calcium and magnesium

infusions: a

retrospective study of 161 patients receiving oxaliplatin combined with

5-Fluorouracil and

leucovorin for advanced colorectal cancer.

Gamelin L, Boisdron-Celle M, Delva R, Guerin-Meyer V, Ifrah N, Morel A, Gamelin

E.

Department of Medical Oncology and Oncopharmacology, INSERM U564, Anticancer

Centre

Papin, Angers Cedex, France.

PURPOSE: Oxaliplatin is active in colorectal cancer. Sensory neurotoxicity is

its dose-

limiting toxicity. It may come from an effect on neuronal voltage-gated Na

channels, via

the liberation one its metabolite, oxalate. We decided to use Ca and Mg as

oxalate

chelators. EXPERIMENTAL DESIGN: A retrospective cohort of 161 patients treated

with

oxaliplatin + 5-fluorouracil and leucovorin for advanced colorectal cancer, with

three

regimens of oxaliplatin (85 mg/m(2)/2w, 100/2w, 130/3w) was identified.

Ninety-six

patients received infusions of Ca gluconate and Mg sulfate (1 g) before and

after

oxaliplatin (Ca/Mg group) and 65 did not. RESULTS: Only 4% of patients withdrew

for

neurotoxicity in the Ca/Mg group versus 31% in the control group (P = 0.000003).

The

tumor response rate was similar in both groups. The percentage of patients with

grade 3

distal paresthesia was lower in Ca/Mg group (7 versus 26%, P = 0.001). Acute

symptoms

such as distal and lingual paresthesia were much less frequent and severe (P =

10(-7)),

and pseudolaryngospasm was never reported in Ca/Mg group. At the end of the

treatment, 20% of patients in Ca/Mg group had neuropathy versus 45% (P = 0.003).

Patients with grade 2 and 3 at the end of the treatment in the 85 mg/m(2)

oxaliplatin

group recovered significantly more rapidly from neuropathy than patients without

Ca/Mg.

CONCLUSIONS: Ca/Mg infusions seem to reduce incidence and intensity of acute

oxaliplatin-induced symptoms and might delay cumulative neuropathy, especially

in 85

mg/m(2) oxaliplatin dosage.