Bao T, Goloubeva O, Pelser C, Porter N, Primrose J, Hester L, Sadowska
M, Lapidus R, Medeiros M, Lao L, Dorsey SG, Badros AZ. Integr Cancer Ther. 2014 May 26.
pii: 1534735414534729. [Epub ahead of print]
The Univ of Maryland School of Medicine, Baltimore, MD, USA firstname.lastname@example.org
Background. Peripheral neuropathy is the dose limiting
toxicity of bortezomib in patients with multiple myeloma (MM).
Objectives. To examine the safety, feasibility and efficacy of AP in reducing bortezomib-induced peripheral neuropathy
Methods. Patients with MM experiencing persistent BIPN >=grade 2
despite adequate medical intervention and discontinuation of bortezomib received 10 AP
treatments for 10 weeks (2×/week for 2 weeks, 1×/week for 4 weeks, and then biweekly for 4
weeks). Responses were assessed by the Clinical Total Neuropathy Score (TNSc),
Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity
(FACT/GOG-Ntx) questionnaire, and the Neuropathy Pain Scale (NPS). Repeated-measures
analysis of variance was used to test for monotonic decline in scores on each of the
measures. Serial serum levels of proinflammatory and neurotrophic cytokines were obtained
at baseline and weeks 1, 2, 4, 8, and 14.
Results. 27 patients with MM were enrolled in the trial. There were no adverse events associated with the AP treatments. TNSc data were deemed invalid and therefore were not reported. At weeks 10 and 14, FACT/GOG-Ntx and
NPS showed significant reduction suggesting decreased pain, and improved function
(p<.0001 for both FACT/GOG-Ntx and NPS at weeks 10 and 14). However, nerve conduction
studies did not change significantly between baseline assessment and end of study. There
was no correlation in serum cytokines for responders versus non-responders.
CONCLUSIONS. AP is safe, feasible and produces subjective improvements in patients'
symptoms in bortezomib-induced peripheral neuropathy. A follow-up randomized controlled
trial is warranted.
© The Author(s) 2014. PMID: 24867959 [PubMed - as supplied by