Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505)

Deirdre R. Pachman, Rui Qin, Drew Seisler, Ellen M Lavoie Smith, Suneetha Kaggal, Paul Novotny, Kathryn J. Ruddy, Jacqueline M. Lafky, Lauren E. Ta, Andreas S. Beutler, Nina Wagner-Johnston, Nathan P. Staff, Axel Grothey, Patrick M. Dougherty, Guido Cavaletti, Charles L. Loprinzi

Research output: Contribution to journalArticle


Purpose: Oxaliplatin and paclitaxel are commonly used chemotherapies associated with acute and chronic neuropathies. There is a need to better understand the similarities and differences of these clinical syndromes. Methods: Neuropathy data were pooled from patients receiving adjuvant oxaliplatin and weekly paclitaxel or every 3 weeks of paclitaxel. Patients completed daily questionnaires after each chemotherapy dose and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire for patients with chemotherapy-induced peripheral neuropathy before each chemotherapy cycle and for 12 months post-treatment. Results: Acute neuropathy symptoms from both drugs peaked around day 3. Acute symptoms experienced in cycle 1 predicted occurrence in subsequent cycles. Paclitaxel-induced acute symptoms were similar in intensity in each cycle and largely resolved between cycles. Oxaliplatin-induced acute symptoms were about half as severe in the first cycle as in later cycles and did not resolve completely between cycles. Both drugs caused a predominantly sensory chronic neuropathy (with numbness and tingling being more common than pain). Oxaliplatin-induced neuropathy worsened after the completion of treatment and began to improve 3 months post-treatment. In contrast, paclitaxel-induced neuropathy began improving immediately after chemotherapy cessation. During treatment, the incidence of paclitaxel sensory symptoms was similar in the hands and feet; with oxaliplatin, the hands were affected more than the feet. Both paclitaxel- and oxaliplatin-induced acute neurotoxicity appeared to predict the severity of chronic neuropathy, more prominently with oxaliplatin. Conclusions: Knowledge of the similarities and differences between neuropathy syndromes may provide insight into their underlying pathophysiology and inform future research to identify preventative treatment approaches.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalSupportive Care in Cancer
StateAccepted/In press - Aug 18 2016


  • Chemotherapy-induced peripheral neuropathy
  • Oxaliplatin neuropathy
  • Paclitaxel neuropathy

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology

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    Pachman, D. R., Qin, R., Seisler, D., Smith, E. M. L., Kaggal, S., Novotny, P., Ruddy, K. J., Lafky, J. M., Ta, L. E., Beutler, A. S., Wagner-Johnston, N., Staff, N. P., Grothey, A., Dougherty, P. M., Cavaletti, G., & Loprinzi, C. L. (Accepted/In press). Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505). Supportive Care in Cancer, 1-10.