Oxaliplatin-induced peripheral neuropathy as a factor influencing the efficacy of the mFOLFOX6 regimen in patients with metastatic colorectal cancer: a retrospective study
- Authors: Natalenko S.A.1,2, Orlova R.V.1,2, Belyak N.P.1,2, Kutukova S.I.1,3, Ksanaeva L.A.1
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Affiliations:
- City Clinical Oncology Dispensary
- Saint Petersburg State University
- Pavlov First Saint Petersburg State Medical University
- Issue: Vol 32, No 6 (2025)
- Pages: 198-207
- Section: Oncology
- URL: https://journals.eco-vector.com/2073-4034/article/view/695563
- DOI: https://doi.org/10.18565/pharmateca.2025.6.198-207
- ID: 695563
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Abstract
Background: Oxaliplatin is an important component of first-line chemotherapy (CT) regimens for metastatic colorectal cancer (mCRC), but its use is often limited by the development of peripheral neuropathy (PN). The optimal relative dose intensity (RDI) that achieves a balance between efficacy and toxicity remains unresolved.
Objective: Evaluation of the effect of oxaliplatin RDI on the incidence of PN and treatment response rates in patients with mCRC.
Materials and methods: A retrospective, single-center cohort study was conducted. Electronic medical records of 142 patients with mCRC receiving CT using the mFOLFOX6 regimen were included. The effect of oxaliplatin RDI on the development of neuropathy (grade ≥ 2), objective response rate, progression-free survival (PFS), and overall survival (OS) was assessed. The association was assessed using logistic regression, Kaplan-Meier analysis, and ROC analysis. The median follow-up was 36 months.
Results: An RDI ≥ 78.9% was significantly associated with a higher incidence of oxaliplatin-induced grade ≥ 2 PN (OR = 8.25, 95% CI: 2.56–26.62; p = 0.0004). No effect of high dose intensity on PFS (OR = 1.24; p = 0.276) and OS (OR = 0.87; p = 0.561) was found, as was the effect on the objective response rate.
Conclusion: A higher oxaliplatin RDI is associated with an increased risk of neuropathy but does not improve survival, supporting the rationale for individual dose reduction.
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About the authors
Sofia A. Natalenko
City Clinical Oncology Dispensary; Saint Petersburg State University
Email: 79818438953@yandex.ru
ORCID iD: 0009-0002-2823-3482
SPIN-code: 4410-1663
Postgraduate Student, Department of Oncology, Medical Institute; Oncologist, Department of Antitumor Drug Therapy No. 10
Russian Federation, Saint Petersburg; Saint PetersburgRashida V. Orlova
City Clinical Oncology Dispensary; Saint Petersburg State University
Author for correspondence.
Email: orlova_rashida@mail.ru
ORCID iD: 0000-0003-4447-9458
Dr. Sci. (Med.), Professor, Head of the Oncology Department, Medical Institute; Chief Specialist in Clinical Oncology
Russian Federation, Saint Petersburg; Saint PetersburgNatalia P. Belyak
City Clinical Oncology Dispensary; Saint Petersburg State University
Email: drnpb@mail.ru
ORCID iD: 0000-0003-0402-6067
SPIN-code: 2937-4858
Cand. Sci. (Med.), Associate Professor, Department of Oncology, Medical Institute; Head of Department of Antitumor Drug Therapy No. 10
Russian Federation, Saint Petersburg; Saint PetersburgSvetlana I. Kutukova
City Clinical Oncology Dispensary; Pavlov First Saint Petersburg State Medical University
Email: dr.s.kutukova@gmail.com
ORCID iD: 0000-0003-2221-4088
SPIN-code: 6735-6556
Dr. Sci. (Med.), Oncologist, Department of Antitumor Drug Therapy No. 10; Professor, Department of Dentistry, Surgical and Maxillofacial Surgery; Associate Professor, Department of Oncology, Faculty of Postgraduate Education
Russian Federation, Saint Petersburg; Saint PetersburgLeylya A. Ksanaeva
City Clinical Oncology Dispensary
Email: leila.ksanaeva@gmail.com
ORCID iD: 0009-0003-6381-3076
Oncologist, Department of Antitumor Drug Therapy No. 10
Russian Federation, Saint PetersburgReferences
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