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The association between sociodemographic, clinical, and potentially preventive therapies with oxaliplatin-induced peripheral neuropathy in colorectal cancer patients

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Abstract

Purpose

The purpose of this retrospective cohort study was to evaluate whether several potentially preventive therapies reduced the rate of oxaliplatin-induced peripheral neuropathy (OIPN) in colorectal cancer patients and to assess the relationship of sociodemographic/clinical factors with OIPN diagnosis.

Methods

Data were obtained from the Surveillance, Epidemiology, and End Results database combined with Medicare claims. Eligible patients were diagnosed with colorectal cancer between 2007 and 2015, ≥ 66 years of age, and treated with oxaliplatin. Two definitions were used to denote diagnosis of OIPN based on diagnosis codes: OIPN 1 (specific definition, drug-induced polyneuropathy) and OIPN 2 (broader definition, additional codes for peripheral neuropathy). Cox regression was used to obtain hazard ratios (HR) with 95% confidence intervals (CI) for the relative rate of OIPN within 2 years of oxaliplatin initiation.

Results

There were 4792 subjects available for analysis. At 2 years, the unadjusted cumulative incidence of OIPN 1 was 13.1% and 27.1% for OIPN 2. For both outcomes, no therapies reduced the rate of OIPN diagnosis. The anticonvulsants gabapentin and oxcarbazepine/carbamazepine were associated with an increased rate of OIPN (both definitions) as were increasing cycles of oxaliplatin. Compared to younger patients, those 75–84 years of age experienced a 15% decreased rate of OIPN. For OIPN 2, prior peripheral neuropathy and moderate/severe liver disease were also associated with an increased hazard rate. For OIPN 1, state buy-in health insurance coverage was associated with a decreased hazard rate.

Conclusion

Additional studies are needed to identify preventive therapeutics for OIPN in cancer patients treated with oxaliplatin.

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Data availability

The SEER-Medicare data that was utilized in this study may be obtained through a data request to the Division of Cancer Control & Population Sciences at the National Cancer Institute.

Code availability

The relavant statistical software code used in this study is available by request from the corresponding author (RBH).

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Acknowledgements

This study was funded by the National Cancer Institute (1 R03 CA241788-01A1). This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database. The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 1NU58DP007156; the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.

Funding

This work was supported by a research grant from the National Cancer Institute (1R03CA241788-01A1).

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Authors and Affiliations

  1. Department of Population Health Sciences, University of Central Florida College of Medicine, 6900 Lake Nona Blvd., Orlando, FL, 328270, USA

    Robert B. Hines, Xiang Zhu & Elizabeth A. Elgin

  2. Department of Statistics & Data Science, University of Central Florida College of Sciences, Orlando, FL, USA

    Christopher Schoborg, Timothy Sumner & Shunpu Zhang

  3. Office of Research, University of Central Florida College of Medicine, Orlando, FL, USA

    Xiang Zhu

  4. Department of Medical Education, University of Central Florida College of Medicine, Orlando, FL, USA

    Elizabeth A. Elgin

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  1. Robert B. Hines
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Contributions

Robert B. Hines: conceptualization, funding acquisition, methodology, formal analysis, and writing.

Christopher Schoborg: data curation, formal analysis, and writing.

Timothy Sumner: data curation, formal analysis, and writing.

Xiang Zhu: data curation, formal analysis, and writing.

Elizabeth A. Elgin: clinical knowledge and writing.

Shunpu Zhang: methodology, study design, and writing.

Corresponding author

Correspondence to Robert B. Hines.

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As this was an observational study of a limited data set without any direct identifiers, this study was deemed exempt from institutional board review by the IRB at the University of Central Florida.

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Hines, R.B., Schoborg, C., Sumner, T. et al. The association between sociodemographic, clinical, and potentially preventive therapies with oxaliplatin-induced peripheral neuropathy in colorectal cancer patients. Support Care Cancer 31, 386 (2023). https://doi.org/10.1007/s00520-023-07850-z

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