Repurposing chemotherapy‐induced peripheral neuropathy grading
Background and Purpose Chemotherapy‐induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient‐reported outcomes measures, but this approach can be challenging in patient care....
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| Veröffentlicht in: | European journal of neurology Jg. 31; H. 12; S. e16457 - n/a |
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| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
England
John Wiley & Sons, Inc
01.12.2024
John Wiley and Sons Inc |
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| ISSN: | 1351-5101, 1468-1331, 1468-1331 |
| Online-Zugang: | Volltext |
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| Abstract | Background and Purpose
Chemotherapy‐induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient‐reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision‐making.
Methods
Data were pooled from two prospective studies of subjects (n = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI‐CTCAE), Total Neuropathy Scale–clinical version (TNSc) items, and the disease‐specific quality of life ‐ Chemotherapy‐Induced Peripheral Neuropathy questionnaire (QLQ‐CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k‐means clustering and internally validated by discriminant functional analysis.
Results
Both NCI‐CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ‐CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ‐CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ‐CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed.
Conclusions
Our results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well‐differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ‐CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation. |
|---|---|
| AbstractList | Background and Purpose
Chemotherapy‐induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient‐reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision‐making.
Methods
Data were pooled from two prospective studies of subjects (n = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI‐CTCAE), Total Neuropathy Scale–clinical version (TNSc) items, and the disease‐specific quality of life ‐ Chemotherapy‐Induced Peripheral Neuropathy questionnaire (QLQ‐CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k‐means clustering and internally validated by discriminant functional analysis.
Results
Both NCI‐CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ‐CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ‐CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ‐CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed.
Conclusions
Our results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well‐differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ‐CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation. Chemotherapy-induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient-reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision-making.BACKGROUND AND PURPOSEChemotherapy-induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient-reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision-making.Data were pooled from two prospective studies of subjects (n = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Total Neuropathy Scale-clinical version (TNSc) items, and the disease-specific quality of life - Chemotherapy-Induced Peripheral Neuropathy questionnaire (QLQ-CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k-means clustering and internally validated by discriminant functional analysis.METHODSData were pooled from two prospective studies of subjects (n = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Total Neuropathy Scale-clinical version (TNSc) items, and the disease-specific quality of life - Chemotherapy-Induced Peripheral Neuropathy questionnaire (QLQ-CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k-means clustering and internally validated by discriminant functional analysis.Both NCI-CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ-CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ-CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ-CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed.RESULTSBoth NCI-CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ-CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ-CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ-CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed.Our results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well-differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ-CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation.CONCLUSIONSOur results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well-differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ-CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation. Background and Purpose Chemotherapy‐induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient‐reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision‐making. Methods Data were pooled from two prospective studies of subjects (n = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI‐CTCAE), Total Neuropathy Scale–clinical version (TNSc) items, and the disease‐specific quality of life ‐ Chemotherapy‐Induced Peripheral Neuropathy questionnaire (QLQ‐CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k‐means clustering and internally validated by discriminant functional analysis. Results Both NCI‐CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ‐CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ‐CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ‐CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed. Conclusions Our results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well‐differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ‐CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation. Chemotherapy-induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient-reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision-making. Data were pooled from two prospective studies of subjects (n = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Total Neuropathy Scale-clinical version (TNSc) items, and the disease-specific quality of life - Chemotherapy-Induced Peripheral Neuropathy questionnaire (QLQ-CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k-means clustering and internally validated by discriminant functional analysis. Both NCI-CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ-CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ-CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ-CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed. Our results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well-differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ-CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation. |
| Author | Cavaletti, Guido Ghignotti, I. Penas‐Prado, M. Mazzeo, A. Lanzani, F. Vanhoutte, E. K. Cornblath, David R. Toscano, A. Dominguez‐Gonzalez, C Briani, C. Brouwer, B. Dorsey, S. G. Bruna, Pere Kalofonos, H. P. Pace, A. Plasmati, R. LindeckPozza, E. Velasco, R. Alberti, Paola Boogerd, M. Padua, L. Grant, R. Argyriou, A. A. Storey, D. Merkies, I. S. J. Koeppen, S. Eurelings, M. Leandri, M. Cavaletti, G. Kerrigan, S. Postma, T. J. Grisold, W. Bakkers, M. Galiè, E. Granata, G. Lalisang, R. I. Velasco, Roser Pessino, A. Lalisang, Roy I. Heimans, J. J. Alberti, P. Psimaras, D. Ricard, D. Pastorelli, F. Cazzaniga, M. Campagnolo, M. Lucchetta, M. Bruna, J. Cortinovis, D. Piatti, M. L. Argyriou, Andreas A. Mattavelli, L. Boogerd, W. Belllucci, M. Rossi, Emanuela Bruna, Jordi Faber, C. G. Briani, Chiara Schenone, Angelo Tomasello, C. Schenone, A. Russo, M. Meijer, R. J. Bidoli, P. Merkies, Ingemar S. J. Psimaras, Dimitri Brandsma, D. Torre, C. Dalla Frigeni, B. Altavilla, G. Binda, D. Hense, J. |
| AuthorAffiliation | 3 Department of Neurology, School of Medicine Johns Hopkins University Baltimore Maryland USA 8 Institute of Neurology, Unité INSERM U1127, CNRS UMR 7225 (Institut du Cerveau et de la Moelle épinière) and OncoNeuroTox Group, Center for Patients With Neurological Complications of Oncologic Treatments Hôpitaux Universitaires la Pitié Salpêtrière Paris France 7 Department of Neurology Maastricht University Medical Center+ Maastricht Limburg the Netherlands 2 Neurological Department Agios Andreas General Hospital of Patras Patras Greece 9 Department of Neurosciences University of Padua Padua Italy 4 Department of Physics, Barcelona Research Center in Multiscale Science and Engineering Universitat Politècnica de Catalunya (UPC), BarcelonaTech, Institut de Tècniques Energètiques Barcelona Spain 1 Unit of Neuro‐Oncology Hospital Universitari de Bellvitge‐Institut Català Oncologia, Bellvitge Institute for Biomedical Research, L'Hospitalet de Llobregat Barcelona Spain 6 Center of Biostatistics for Cli |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39282967$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1097_CCO_0000000000001112 crossref_primary_10_1182_bloodadvances_2025016734 |
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| ContentType | Journal Article |
| Contributor | Kalofonos, H P Plasmati, R Hense, J Russo, M Torre, C Dalla Pace, A Grant, R Storey, D Cazzaniga, M Velasco, R Postma, T J Toscano, A Bruna, J Argyriou, A A Lanzani, F Lucchetta, M Belllucci, M Briani, C Koeppen, S Bidoli, P Heimans, J J Grisold, W Lalisang, R I Ricard, D Ghignotti, I Pastorelli, F LindeckPozza, E Boogerd, M Alberti, P Schenone, A Leandri, M Galiè, E Merkies, I S J Kerrigan, S Penas-Prado, M Vanhoutte, E K Granata, G Tomasello, C Altavilla, G Brouwer, B Frigeni, B Boogerd, W Psimaras, D Eurelings, M Cortinovis, D Brandsma, D Dominguez-Gonzalez, C Padua, L Dorsey, S G Meijer, R J Cavaletti, G Pessino, A Piatti, M L Faber, C G Campagnolo, M Binda, D Mattavelli, L Bakkers, M Mazzeo, A |
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| Copyright | 2024 The Author(s). published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| References_xml | – volume: 27 start-page: 2599 issue: 7 year: 2019 end-page: 2608 article-title: Rasch model‐based testing of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire–chemotherapy‐induced peripheral neuropathy (QLQ‐CIPN20) using Alliance for clinical trials in oncology (Alliance) A151408 study data publication-title: Support Care Cancer – volume: 73 start-page: 2515 issue: 10 year: 1994 end-page: 2519 article-title: Full dose vincristine (without 2‐mg dose limit) in the treatment of lymphomas publication-title: Cancer – volume: 166 start-page: 519 issue: 2 year: 2017 end-page: 526 article-title: Long‐term peripheral neuropathy symptoms in breast cancer survivors publication-title: Breast Cancer Res Treat – volume: 23 start-page: 3116 issue: 12 year: 2012 end-page: 3122 article-title: Peripheral neurotoxicity of oxaliplatin in combination with 5‐fluorouracil (FOLFOX) or capecitabine (XELOX): a prospective evaluation of 150 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| Snippet | Background and Purpose
Chemotherapy‐induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment.... Chemotherapy-induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations... Background and Purpose Chemotherapy‐induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment.... |
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| SubjectTerms | Adult Aged Antineoplastic Agents - adverse effects Cancer Chemotherapy chemotherapy‐induced peripheral neuropathy Classification Cluster analysis Clustering Decision making Demographics Female Functional analysis Health services Heterogeneity Humans Male Middle Aged Neoplasms - drug therapy Neuropathies Neurotoxicity Original Patients patient‐reported outcome measure Peripheral Nervous System Diseases - chemically induced Peripheral Nervous System Diseases - diagnosis Peripheral neuropathy Physicians Prospective Studies Quality of Life Severity of Illness Index Subgroups Terminology |
| Title | Repurposing chemotherapy‐induced peripheral neuropathy grading |
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