Antineoplastics
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Reactions 1382 - 17 Dec 2011 Antineoplastics Fatigue, dry skin and peripheral neuropathy: case report A man in his 40s developed fatigue, dry skin and peripheral neuropathy during chemotherapy for recurrent gastric cancer [not all times to reaction onset stated; outcomes not clearly stated]. The man presented with recurrent disease at the age of 42 years in May 2008, and palliative chemotherapy according to the EOX regimen was initiated; therapy comprised 3-week cycles of epirubicin 50 mg/m 2 and oxaliplatin 130 mg/m 2 on day 1, and capecitabine 625 mg/m 2 twice daily for 21 days [routes not stated]. The man achieved complete remission after 6 cycles, but therapy was withdrawn due to worsening fatigue, dry skin and sensory neuropathy in October 2008, without completing the recommended 8 cycles. His fatigue was slowly improving 3 months later, but he experienced disease progression with peritoneal carcinosis and underwent surgical resection followed by doxorubicin and cisplatin. In September 2009, he again required surgery for peritoneal carcinosis and disease manifestations. After surgery, second-line chemotherapy with 2-weekly cycles of oxaliplatin 85 µg/m 2 and folinic acid [leucovorin] 200 mg/m 2 on day 1, and a 24-hour infusion of fluorouracil 2600 mg/m 2 (FLO) on day 1, was commenced [routes not stated]. The man again achieved complete remission after 6 cycles, but developed incipient grade 1 peripheral neuropathy after 12 cycles (total oxaliplatin dose 1800 mg/m 2 ). Therapy was stopped in March 2010. He also experienced worsening fatigue. That May, he reported only minor neuropathy and fatigue, and third-line FOLFIRI-T chemotherapy was begun, with 2-weekly cycles of irinotecan 180 mg/m 2 on day 1, folinic acid 200 mg/m 2 followed by a fluorouracil 400 mg/m 2 bolus and 600 mg/m 2 infusion (over 22 hours) on days 1 and 2, and trastuzumab 6 mg/kg as a first dose followed by 4 mg/kg on day 1 [routes not stated]. His neuropathy did not worsen, and he achieved complete remission after 12 cycles. However, he experienced progressive fatigue during the 6 months’ therapy; most prominent on days 4–6 after drug administration. He insisted on stopping FOLFIRI, but continued trastuzumab. He maintained complete remission. Weissinger F, et al. Successful treatment of a patient with HER2-positive metastatic gastric cancer with third-line combination therapy with irinotecan, 5-fluorouracil, leucovorin and trastuzumab (FOLFIRI-T). Onkologie 34: 548-551, No. 10, Oct 2011. Available from: URL: http://dx.doi.org/10.1159/000332226 - Germany 803064482 1 Reactions 17 Dec 2011 No. 1382 0114-9954/10/1382-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1382 - 17 Dec 2011
Antineoplastics
Fatigue, dry skin and peripheral neuropathy:case report
A man in his 40s developed fatigue, dry skin andperipheral neuropathy during chemotherapy for recurrentgastric cancer [not all times to reaction onset stated;outcomes not clearly stated].
The man presented with recurrent disease at the age of42 years in May 2008, and palliative chemotherapyaccording to the EOX regimen was initiated; therapycomprised 3-week cycles of epirubicin 50 mg/m2 andoxaliplatin 130 mg/m2 on day 1, and capecitabine625 mg/m2 twice daily for 21 days [routes not stated]. Theman achieved complete remission after 6 cycles, buttherapy was withdrawn due to worsening fatigue, dry skinand sensory neuropathy in October 2008, withoutcompleting the recommended 8 cycles.
His fatigue was slowly improving 3 months later, but heexperienced disease progression with peritoneal carcinosisand underwent surgical resection followed by doxorubicinand cisplatin. In September 2009, he again requiredsurgery for peritoneal carcinosis and diseasemanifestations. After surgery, second-line chemotherapywith 2-weekly cycles of oxaliplatin 85 µg/m2 and folinic acid[leucovorin] 200 mg/m2 on day 1, and a 24-hour infusion offluorouracil 2600 mg/m2 (FLO) on day 1, was commenced[routes not stated]. The man again achieved completeremission after 6 cycles, but developed incipient grade 1peripheral neuropathy after 12 cycles (total oxaliplatin dose1800 mg/m2). Therapy was stopped in March 2010. He alsoexperienced worsening fatigue. That May, he reported onlyminor neuropathy and fatigue, and third-line FOLFIRI-Tchemotherapy was begun, with 2-weekly cycles ofirinotecan 180 mg/m2 on day 1, folinic acid 200 mg/m2
followed by a fluorouracil 400 mg/m2 bolus and 600 mg/m2
infusion (over 22 hours) on days 1 and 2, and trastuzumab6 mg/kg as a first dose followed by 4 mg/kg on day 1 [routesnot stated]. His neuropathy did not worsen, and heachieved complete remission after 12 cycles. However, heexperienced progressive fatigue during the 6 months’therapy; most prominent on days 4–6 after drugadministration. He insisted on stopping FOLFIRI, butcontinued trastuzumab. He maintained completeremission.Weissinger F, et al. Successful treatment of a patient with HER2-positivemetastatic gastric cancer with third-line combination therapy with irinotecan,5-fluorouracil, leucovorin and trastuzumab (FOLFIRI-T). Onkologie 34: 548-551,No. 10, Oct 2011. Available from: URL: http://dx.doi.org/10.1159/000332226 -Germany 803064482
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Reactions 17 Dec 2011 No. 13820114-9954/10/1382-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
