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MASCC Neurological Complications Study Group

Leadership

Chair: Charles Loprinzi, MD (cloprinzi@mayo.edu) - USA
Vice-Chair: Alex Chan, PharmD (phaac@nus.edu.sg) - Singapore
Vice-Chair: Maryam Lustberg (Maryam.lustberg@osumc.edu) - USA

Study Group Minutes
2016 Minutes alt - Annual Meeting - Adelaide, Australia

Introduction

Since the birth of oncology as a distinct medical discipline, oncologists have considered myelosuppression and its attendant problems to be the dose-limiting and most important toxicities of radiation and chemotherapy. Within the last decade, however, the availability of colony-stimulating factors, and dramatic improvements in transfusion medicine, antibiotic therapy, and supportive care have made the bone marrow more robust. Today, a strong case can be made that the nervous system has replaced the bone marrow as the most important dose-limiting end organ for cancer therapy. Similarly, for the growing number of cancer survivors, the nervous system rather than the hematopoietic system more frequently affects the quality of survival and the economic productivity of survivors. At the same time, longer survival, more effective systemic therapies, and the relative inaccessibility of the nervous system to these therapies has resulted in a steady increase in the frequency of direct nervous system involvement by non-nervous system cancer.

All components of the central and peripheral nervous system are susceptible to injury by cancer therapy. Among the most prominent targets are the brain (resulting in cognitive impairment, neuroendocrine dysfunction, depression, anxiety, and social disintegration) and the peripheral nerves (resulting in neuropathy). The brain, spinal epidural space and leptomeninges are all common nervous system targets for metastatic spread of tumor and subsequent neurologic compromise.

Purpose

The guiding purpose of the Neurologic Complications Study Group is to raise awareness within the healthcare community and among patients and advocacy groups about the frequency, importance, and complexity of these problems. To accomplish this goal, the group initiates and supports collaborative research designed to expand our knowledge of the nature, treatment, and prevention of neurologic complications. This group also serves as a resource for information about these problems and develops evidence-based guidelines. Because these issues have only recently garnered attention from the academic community, research on  their characteristics, risk factors, and frequency is limited.

Objectives

The Study Group was formed to focus on the following objectives:

  • To develop reliable assessment tools
  • To assess internationally potential variation in the significance of neurological complications
  • To survey members’ opinions and needs regarding neurological complications 
  • To contribute program content to MASCC meetings and practical resources to the MASCC website

Because these problems are important to all patients with cancer, a multidisciplinary approach is essential. In particular, this study group promotes close collaboration with the Psychosocial Oncology and the Rehabilitation and Survivorship Study Groups.

Past Workshop

Cancer-Related Cognitive Impairment. MASCC/ISOO Annual Meeting, Adelaide, Australia, 2016.

Research Highlight

Docetaxel-Induced Peripheral Neuropathy in Breast Cancer Survivors
Lise Eckhoff and her colleagues have conducted research on docetaxel-induced neuropathy among Danish women with early-stage breast cancer, confirming that women with chemotherapy-induced PN received significantly lower cumulative doses of chemotherapy. In other work, Eckhoff et al. have found support for the theory that oxidative stress is involved in docetaxel-induced PN.They have also investigated the persistence of docetaxel-induced neuropathy and its impact on quality of life among breast cancer survivors.  >> Read More

Ongoing Research

Chemotherapy-Induced Neuropathy Research Projects of MASCC Neurologic Complications Study Group Members
Differential Gene Expression in Chemotherapy-Induced Neuropathy alt
Project Status: 14 patients analyzed (before and after chemotherapy); recruiting more patients (June 2012)

Recent Publications

Cheung YT, Ng T, Shwe M, Ho HK, Foo KM, Cham MT, Lee JA, Fan G, Tan YP, Yong WS, Madhukumar P, Loo SK, Ang SF, Wong M, Chay WY, Ooi WS, Dent RA, Yap YS, Ng R, Chan A. Association of pro-inflammatory cytokines and chemotherapy-associated cognitive impairment in breast cancer patients: A multi-centered, prospective, cohort study. Ann Oncol. 2015 Jul;26(7):1446-51.

Shinde SS, Seisler D, Soori G, Atherton PJ, Pachman DR, Lafky J, Ruddy KJ, Loprinzi CL. Can pregabalin prevent paclitaxel-associated neuropathy? An ACCRU pilot trial. Support Care Cancer. 2015 Jul 9. [Epub ahead of print]

Steensma DP, Dakhil SR, Novotny PJ, Sloan JA, Johnson DB, Anderson DM, Mattar BI, Moore DF Jr, Md, Nikcevich D, Loprinzi CL. A randomized comparison of once weekly epoetin alfa to extended schedule epoetin or darbepoetin in chemotherapy-associated Anemia. Am J Hematol. 2015 Jul 6 [Epub ahead of print]

Boora GK, Kulkarni AA, Kanwar R, Beyerlein P, Qin R, Banck MS, Ruddy KJ, Pleticha J, Lynch CA, Behrens RJ, Züchner S, Loprinzi CL, Beutler AS. Association of the Charcot-Marie-Tooth disease gene ARHGEF10 with paclitaxel induced peripheral neuropathy in NCCTG N08CA (Alliance). J Neurol Sci. 2015 Jun 27. [Epub ahead of print]

Steensma DP, Sasu BJ, Sloan JA, Tomita DK, Loprinzi CL. Serum hepcidin levels predict response to intravenous iron and darbepoetin in chemotherapy-associated anemia. Blood. 2015 Jun 4;125(23):3669-71.

Lewis MA, Zhao F, Jones D, Loprinzi CL, Brell J, Weiss M, Fisch MJ. Neuropathic symptoms and their risk factors in medical oncology outpatients with colorectal vs. breast, lung, or prostate cancer: Results from a prospective multicenter study. J Pain Symptom Manage. 2015 Jun;49(6):1016-24.

Ewertz M, Qvortrup C, Eckhoff L. Chemotherapy-induced peripheral neuropathy in patients treated with taxanes and platinum derivatives. Acta Oncol. 2015 May;54(5):587-91.

Pachman DR, Weisbrod BL, Seisler DK, Barton DL, Fee-Schroeder KC, Smith TJ, Lachance DH, Liu H, Shelerud RA, Cheville AL, Loprinzi CL. Pilot evaluation of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2015 Apr;23(4):943-51.

Eckhoff L, Feddersen S, Knoop AS, Ewertz M, Bergmann TK. Docetaxel-induced neuropathy: a pharmacogenetic case-control study of 150 women with early-stage breast cancer. Acta Oncol. 2015 Apr;54(4):530-7.

Chan RJ, McCarthy AL, Devenish J, Sullivan KA, Chan A. Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer. Eur J Cancer. 2015 Mar;51(4):437-50.

Jones D, Zhao F, Brell J, Lewis MA, Loprinzi CL, Weiss M, Fisch MJ. Neuropathic symptoms, quality of life, and clinician perception of patient care in medical oncology outpatients with colorectal, breast, lung, and prostate cancer. J Cancer Surviv. 2015 Mar;9(1):1-10.

Ruddy, KJ, Majithia, N, Pachman DR, Beutler AS, Loprinzi CL.Chemotherapy-induced neuropathy—Where are we now? Oncology & Hematology Review, Spring 2015;11(1):53–5

Eckhoff L, Knoop A, Jensen M, Ewertz M. Persistence of docetaxel-induced neuropathy and impact on quality of life among breast cancer survivors. Eur J Cancer. 2015 Feb;51(3):292-300.

Johnson C, Pankratz VS, Velazquez AI, Aakre JA, Loprinzi CL, Staff NP, Windebank AJ, Yang P. Candidate pathway-based genetic association study of platinum and platinum-taxane related toxicity in a cohort of primary lung cancer patients. J Neurol Sci. 2015 Feb 15;349(1-2):124-8.

Ng T, Khor CC, Ho HK, Chan A. The genetic variants underlying breast cancer treatment-induced chronic and late toxicities: a systematic review. Cancer Treatment Reviews 2014; Dec;40(10):1199-1214.

Pachman DR, Watson JC, Loprinzi CL.Therapeutic strategies for cancer treatment related peripheral neuropathies. Curr Treat Options Oncol. 2014 Dec;15(4):567-80.

Eckhoff L, Feddersen S, Knoop AS, Ewertz M, Bergmann TK. Docetaxel-induced neuropathy: A pharmacogenetic case-control study of 150 women with early-stage breast cancer. Acta Oncol. 2014 Nov 10:1-8.

Pachman DR, Weisbrod BL, Seisler DK, Barton DL, Fee-Schroeder KC, Smith TJ, Lachance DH, Liu H, Shelerud RA, Cheville AL, Loprinzi CL. Pilot evaluation of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2014 Sep 24. [Epub ahead of print]

Pachman DR, Watson JC, Lustberg MB, Wagner-Johnston ND, Chan A, Broadfield L, Cheung YT, Steer C, Storey DJ, Chandwani KD, Paice J, Jean-Pierre P, Oh J, Kamath J, Fallon M, Strik H, Koeppen S, Loprinzi CL. Management options for established chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2014 Aug;22(8):2281-95.

Cheung YT, Foo YL, Shwe M, Tan YP, Fan G, Yong WS, Preetha M, Ooi WS, Chay WY, Dent R, Ang SF, Lo SK, Yap YS, Ng R, Chan A.Minimal clinically important difference (MCID) for the functional assessment of cancer therapy: cognitive function (FACT-Cog) in breast cancer patients. J Clin Epidemiology 2014; Jul;67(7):811-20.

Leal AD, Qin R, Atherton PJ, Haluska P, Behrens RJ, Tiber CH, Watanaboonyakhet P, Weiss M, Adams PT, Dockter TJ, Loprinzi CL; Alliance for Clinical Trials in Oncology. North Central Cancer Treatment Group/Alliance trial N08CA-the use of glutathione for prevention of paclitaxel/carboplatin-induced peripheral neuropathy: a phase 3 randomized, double-blind, placebo-controlled study. Cancer. 2014 Jun 15;120(12):1890-7.

Loprinzi CL, Qin R, Dakhil SR, Fehrenbacher L, Flynn KA, Atherton P, Seisler D, Qamar R, Lewis GC, Grothey A. Phase III randomized, placebo-controlled, double-blind study of intravenous calcium and magnesium to prevent oxaliplatin-induced sensory neurotoxicity (N08CB/Alliance). J Clin Oncol. 2014 Apr 1;32(10):997-1005


Please contact the Study Group Chairs above with your questions.
MASCC Study Group Coordinator, Don Gubitosa