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Met Taxol meer neuropathische pijn

Met Taxol meer neuropathische pijn, volgens een persbericht van een onderzoek dat op 23 November 2009 gepubliceerd werd. Dat is nu niet helemaal nieuw, dat wisten we al jaren. Maar ja, de kranten moeten ook vol. Veel van de zogenaamde nieuwe gegevens in de kranten zijn vaak al veel langer bekend. Maar toch even aandacht voor dit verhaal:

Breast cancer patients treated with the chemotherapy drug Taxol (paclitaxel) are more likely to develop chronic neuropathic pain, according to research published in The Journal of Pain, the peer review publication of the American Pain Society.

Researchers from the University of Texas MD Anderson Cancer Center conducted a survey of breast cancer patients who participated in clinical trials of Taxol from 1994 to 2001. There were 240 respondents. The purpose of the study was to determine the association between chemotherapy-induced peripheral neuropathy(CIPN) and neuropathic pain in breast cancer patients treated with Taxol. The authors noted that few studies have examined the extent to which breast cancer survivors who experience CIPN during chemotherapy go on to develop chronic neuropathic pain.

Though survival rates for breast cancer have increased significantly, chemotherapy agents that make survival possible can cause structural damage to peripheral nerves, causing chronic pain from the resulting dysfunction in the nervous system. Dose-limiting toxicity for many chemotherapeutic agents is peripheral neuropathy.

The study results showed that breast-cancer patients who had experienced CIPN during their treatment with Taxol were three times more likely to eventually be diagnosed with chronic neuropathic pain. Taxol-treated patients, therefore, should be regularly monitored for neuropathic pain beyond treatment.

The authors pointed out that the same cellular mechanism altered by Taxol to kill tumors can be toxic to normal tissue. They explained further that patients at MD Anderson given weekly doses of Taxol are monitored closely for symptoms of worsening CIPN. In some cases, physicians and patients should review the risks and benefits for continuing Taxol if worsening neuropathy is likely.

Source: University of Texas MD Anderson Cancer Center

Dus de aanbeveling is om vrouwen die een kuur met Taxol krijgen, ook na de kuur te volgen om eventuele neuropathische pijn adequaat te kunnen behandelen. De Taxolen beschadigen namelijk de axonen, waarlangs de zenuwimpuls reist, door de filamenten erin te desorganiseren. [1] De studie is te vinden in het Journal of Pain. [2] En bevindingen uit andere groepen bevestigen het. [3]

November 2009: prof. dr. Jan M. Keppel Hesselink, arts-farmacoloog

Referentie

[1] Shemesh OA, Spira ME. | Paclitaxel induces axonal microtubules polar reconfiguration and impaired organelle transport: implications for the pathogenesis of paclitaxel-induced polyneuropathy. | Acta Neuropathol. | 2010 Feb;119(2):235-48. Epub 2009 Aug 30.

[2] Reyes-Gibby CC, Morrow PK, Buzdar A, Shete S. | Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel. | J Pain. | 2009 Nov;10(11):1146-50.

[3] Kuroi K, Shimozuma K, Ohashi Y, Hisamatsu K, Masuda N, Takeuchi A, Aranishi T, Morita S, Ohsumi S, Hausheer FH. | Prospective assessment of chemotherapy-induced peripheral neuropathy due to weekly paclitaxel in patients with advanced or metastatic breast cancer (CSP-HOR 02 study). | Support Care Cancer. | 2008 Dec 17. [Epub ahead of print]

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