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. 2021 Nov 4:12:744085.
doi: 10.3389/fphar.2021.744085. eCollection 2021.

Colorectal Cancer Survivors Suffering From Sensory Chemotherapy-Induced Peripheral Neuropathy Are Not a Homogenous Group: Secondary Analysis of Patients' Profiles With Oxaliplatin-Induced Peripheral Neuropathy

Nicolas Kerckhove  1   2   3 , Marie Selvy  1 , Céline Lambert  2 , Coralie Gonneau  1 , Gabrielle Feydel  2 , Caroline Pétorin  4 , Agnès Vimal-Baguet  4 , Sergey Melnikov  5 , Sharif Kullab  6 , Mohamed Hebbar  7 , Olivier Bouché  8 , Florian Slimano  9 , Vincent Bourgeois  10 , Valérie Lebrun-Ly  11 , Frédéric Thuillier  11 , Thibault Mazard  12 , David Tavan  13 , Kheir Eddine Benmammar  14 , Brigitte Monange  14 , Mohamed Ramdani  15 , Denis Péré-Vergé  16 , Floriane Huet-Penz  17 , Ahmed Bedjaoui  18 , Florent Genty  19 , Cécile Leyronnas  20 , Jérôme Busserolles  1   3 , Sophie Trévis  21 , Vincent Pinon  21 , Denis Pezet  22 , David Balayssac  1   2
Affiliations

Colorectal Cancer Survivors Suffering From Sensory Chemotherapy-Induced Peripheral Neuropathy Are Not a Homogenous Group: Secondary Analysis of Patients' Profiles With Oxaliplatin-Induced Peripheral Neuropathy

Nicolas Kerckhove et al. Front Pharmacol. .

Abstract

Oxaliplatin, a pivotal drug in the management of colorectal cancer, causes chemotherapy-induced peripheral neuropathy (CIPN) in a third of cancer survivors. Based on a previous cross-sectional study assessing oxaliplatin-related sensory CIPN in colorectal cancer survivors, a secondary analysis was designed to explore the possibility that different clusters of patients may co-exist among a cohort of patients with oxaliplatin-related CIPN. Other objectives were to characterize these clusters considering CIPN severity, anxiety, depression, health-related quality of life (HRQOL), patients' characteristics and oxaliplatin treatments. Among the 96 patients analyzed, three clusters were identified (cluster 1: 52, cluster 2: 34, and cluster 3: 10 patients). Clusters were significantly different according to CIPN severity and the proportion of neuropathic pain (cluster 1: low, cluster 2: intermediate, and cluster 3: high). Anxiety, depressive disorders and HRQOL alteration were lower in cluster 1 in comparison to clusters 2 and 3, but not different between clusters 2 and 3. This study underlines that patients with CIPN are not a homogenous group, and that CIPN severity is associated with psychological distress and a decline of HRQOL. Further studies are needed to explore the relation between clusters and CIPN management.

Keywords: chemotherapy-induced peripheral neuropathy; cluster analysis; colorectal cancer; neuropathic pain; oxaliplatin.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study flowchart.
FIGURE 2
FIGURE 2
Scores of the QLQ-CIPN20 (sensory, motor and vegetative) among the three clusters of patients with a sensory CIPN. Omnibus p-value: *p < 0.05; **p < 0.01; ***p < 0.001; ns, not significant. Significant difference (p < 0.05, post hoc analysis) between: a, cluster 1 and cluster 2; b, cluster 1 and cluster 3; c: cluster 2 and cluster 3.
FIGURE 3
FIGURE 3
Characteristics of pain, anxiety, depression and HRQOL among the four clusters of patients with a sensory CIPN. Anxiety and depression were assessed thanks to the HADS questionnaire and classified according to normal (≤7/21), suggestive (8–10/21) and indicative (≥11/21) scores of anxiety or depression. HRQOL was assessed thanks to the QLQ-C30 questionnaire and classified according each third of the scores (<33.3 [33.3–66.7 [, and ≥66.7) for the global health scale, the functional scales (physical, role functioning, emotional, cognitive, and social), and the symptomatic scales (fatigue, nausea/vomiting, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Omnibus p-value: *p < 0.05; **p < 0.01; ***p < 0.001; ns, not significant. Significant difference (p < 0.05, post hoc analysis) between: a, cluster 1 and cluster 2; b, cluster 1 and cluster 3; c: cluster 2 and cluster 3.
FIGURE 4
FIGURE 4
Summary of cluster characteristics. Figure_supplementary file: Multiple correspondence analysis (MCA) plot of variables (A) and patients (B). QLQ-CIPN20–17 (3 + 4): QLQ-CIPN20 questionnaire blurred vision, score “quite a bit” and “very much” HADS depression [8; 10]: HADS questionnaire, depression scale, suggestive scores between 8 and 10.QLQ-C30 - AP ≥ 66.7: QLQ-C30 questionnaire appetite loss, scores higher than or equal to 66.7. QLQ-C30 - AP [33.3; 66.7[: QLQ-C30 questionnaire appetite loss, scores between 33.3 and 66.7 (66.7 excluded). QLQ-C30 - EF < 33.3: QLQ-C30 questionnaire emotional functioning, scores lower than 33.3. QLQ-C30-CF < 33.3: QLQ-C30 questionnaire cognitive functioning, scores lower than 33.3. QLQ-C30-CF [33.3; 66.7 [: QLQ-C30 questionnaire cognitive functioning, scores between 33.3 and 66.7 (66.7 excluded). QLQ-C30-FA < 33.3: QLQ-C30 questionnaire fatigue, scores lower than 33.3. QLQ-C30-PA ≥ 66.7: QLQ-C30 questionnaire pain, scores higher than or equal to 66.7. QLQ-C30-RF < 33.3: QLQ-C30 questionnaire role functioning, scores lower than 33.3. QLQ-C30-RF [33.3; 66.7 [: QLQ-C30 questionnaire role functioning, scores between 33.3 and 66.7 (66.7 excluded) QLQ-C30-QOL <33.3: C30 questionnaire global health status, scores lower than 33.3 QLQ-C30-SF < 33.3: QLQ-C30 questionnaire social functioning, scores lower than 33.3. QLQ-C30 - SL < 33.3: QLQ-C30 questionnaire insomnia, scores lower than 33.3.
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