Characterization of chemotherapy-induced peripheral neuropathy using patient-reported outcomes and quantitative sensory testing

Abstract

Purpose

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating side effect in cancer survivors. This study aimed to assess the characteristics of quantitative sensory testing (QST) and its correlation with patient-reported outcomes (PROs) in cancer patients with and without CIPN.

Methods

We conducted a cross-sectional analysis using baseline data from two clinical trials in solid tumor cancer survivors with no CIPN symptoms rated < 2 on a 0–10 Numerical Rating Scale (NRS) or moderate-to-severe CIPN rated ≥ 4 on the NRS. We collected PROs (NRS, Neuropathic Pain Scale, and Functional Assessment of Cancer Therapy-Gynecologic Oncology Group/Neurotoxicity subscale at baseline. QST [Tactile Threshold (TT), Vibration Threshold (VT), Thermal Threshold (THT)] measurements were used to assess sensory fiber function; they were compared between patients with and without CIPN using Wilcoxon rank-sum tests. We used Spearman correlation coefficients to estimate associations between PROs and QST in all patients.

Results

Among 116 participants with CIPN (median NRS 5.00) and 10 participants without CIPN (median NRS 0.00), the median (interquartile range) TT was 3.84 (3.47, 4.12) and 3.53 (3.00, 3.84) in feet, respectively (p = 0.043). The median VT was 17.90 (9.42, 26.95) and 7.73 (5.94, 11.11) in feet, respectively (p = 0.001). Thermal cool threshold was 30.00 °C (28.90, 30.57) and 30.67 °C (30.57, 30.93), respectively (p = 0.007). Correlation coefficients between PROs and QST measures ranged between 0.02 and 0.50 in absolute magnitude.

Conclusion

Patients with moderate-to-severe CIPN had significantly impaired tactile, vibratory, and thermal thresholds compared to patients without CIPN. QST correlates with PROs, suggesting CIPN symptom severity may correspond to sensory fiber functionality. QST may be incorporated into future CIPN research.

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Funding

This manuscript is supported in part by a grant from the National Institutes of Health/National Cancer Institute Cancer Center (P30 CA008748) and the Translational and Integrative Medicine Research Fund at Memorial Sloan Kettering Cancer Center.

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Affiliations

Authors

Contributions

WIZ: conceptualization, formal analysis, investigation, methodology, validation, writing—original draft, writing—review and editing. REB: conceptualization, formal analysis, investigation, methodology, writing—original draft, writing—review and editing. AK: investigation, writing—review and editing. CC: investigation, writing—review and editing. SQL: data curation, investigation, software, writing—review and editing. LP: data curation, investigation, project administration, writing—review and editing. CS: investigation, writing—review and editing. KSP: conceptualization, investigation, writing—review and editing. SEH: investigation, writing—review and editing. JJM: investigation, resources, writing—review and editing. TB: conceptualization, formal analysis, funding acquisition, investigation, methodology, resources, supervision, validation, writing—original draft, writing—review and editing.

Corresponding author

Correspondence to Ting Bao.

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Conflict of interest

Dr. Mao reports grants from Tibet Cheezheng Tibetan Medicine Co., Ltd. and from Zhongke Health International, LLC outside the submitted work. Dr. Harte reports grants and personal fees from Aptinyx, and grants and other from Arbor Medical Innovations, outside the submitted work. In addition, Dr. Harte has a patent US9307906 licensed. Dr. Panageas reports other from Johnson and Johnson, Pfizer, Viking Therapeutics, and Catalyst Biotech, outside the submitted work. All other authors report no potential conflicts of interest.

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Zhi, W.I., Baser, R.E., Kwon, A. et al. Characterization of chemotherapy-induced peripheral neuropathy using patient-reported outcomes and quantitative sensory testing. Breast Cancer Res Treat (2021). https://doi.org/10.1007/s10549-020-06079-2

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Keywords

  • Cancer survivors
  • Chemotherapy
  • Neuropathy
  • Patient-reported outcome measures
  • Quantitative sensory testing