Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review

Purpose Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This...

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Veröffentlicht in:Cancer chemotherapy and pharmacology Jg. 84; H. 3; S. 471 - 485
Hauptverfasser: Madsen, Marie Lindhard, Due, Hanne, Ejskjær, Niels, Jensen, Paw, Madsen, Jakob, Dybkær, Karen
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2019
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ISSN:0344-5704, 1432-0843, 1432-0843
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Abstract Purpose Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This dose-limiting side-effect can diminish quality of life and, furthermore, cause discontinuation of vincristine treatment. The present review elucidates the current knowledge regarding vincristine-induced neuropathy in hematologic malignancies, focusing on neuropathy assessment, clinical and molecular predictive markers, drug–drug interference, prevention, and treatment. Methods This review is conducted by a systematic search strategy for the identification of relevant literature in the PubMed and Embase databases. Results No clinical parameters displayed convincing potential as predictors of vincristine-induced neuropathy; however, preexisting neuropathy was consistently reported to be associated with an increased risk of neurotoxicity. In contrast, molecular markers, including polymorphisms in genes involved in the pharmacodynamics and pharmacokinetics of vincristine, displayed great potential as predictive markers of neuropathy incidence and severity. Furthermore, antifungal drugs, such as itraconazole and voriconazole, decrease the metabolism of vincristine and consequently lead to severe neuropathy when co-administered with vincristine, underscoring why fluconazole should be the antifungal drug of choice. Conclusion Reports from the 71 included studies clearly emphasize the lack of consistency in neuropathy assessment, grading systems, and reporting, making it difficult to interpret results between studies. Thus, truer clinical and molecular markers could emerge if the consistency of neuropathy detection and reporting increases by the use of conventional standardized neuropathy assessment tools and grading scales.
AbstractList Purpose Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This dose-limiting side-effect can diminish quality of life and, furthermore, cause discontinuation of vincristine treatment. The present review elucidates the current knowledge regarding vincristine-induced neuropathy in hematologic malignancies, focusing on neuropathy assessment, clinical and molecular predictive markers, drug–drug interference, prevention, and treatment. Methods This review is conducted by a systematic search strategy for the identification of relevant literature in the PubMed and Embase databases. Results No clinical parameters displayed convincing potential as predictors of vincristine-induced neuropathy; however, preexisting neuropathy was consistently reported to be associated with an increased risk of neurotoxicity. In contrast, molecular markers, including polymorphisms in genes involved in the pharmacodynamics and pharmacokinetics of vincristine, displayed great potential as predictive markers of neuropathy incidence and severity. Furthermore, antifungal drugs, such as itraconazole and voriconazole, decrease the metabolism of vincristine and consequently lead to severe neuropathy when co-administered with vincristine, underscoring why fluconazole should be the antifungal drug of choice. Conclusion Reports from the 71 included studies clearly emphasize the lack of consistency in neuropathy assessment, grading systems, and reporting, making it difficult to interpret results between studies. Thus, truer clinical and molecular markers could emerge if the consistency of neuropathy detection and reporting increases by the use of conventional standardized neuropathy assessment tools and grading scales.
PurposeVincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This dose-limiting side-effect can diminish quality of life and, furthermore, cause discontinuation of vincristine treatment. The present review elucidates the current knowledge regarding vincristine-induced neuropathy in hematologic malignancies, focusing on neuropathy assessment, clinical and molecular predictive markers, drug–drug interference, prevention, and treatment.MethodsThis review is conducted by a systematic search strategy for the identification of relevant literature in the PubMed and Embase databases.ResultsNo clinical parameters displayed convincing potential as predictors of vincristine-induced neuropathy; however, preexisting neuropathy was consistently reported to be associated with an increased risk of neurotoxicity. In contrast, molecular markers, including polymorphisms in genes involved in the pharmacodynamics and pharmacokinetics of vincristine, displayed great potential as predictive markers of neuropathy incidence and severity. Furthermore, antifungal drugs, such as itraconazole and voriconazole, decrease the metabolism of vincristine and consequently lead to severe neuropathy when co-administered with vincristine, underscoring why fluconazole should be the antifungal drug of choice.ConclusionReports from the 71 included studies clearly emphasize the lack of consistency in neuropathy assessment, grading systems, and reporting, making it difficult to interpret results between studies. Thus, truer clinical and molecular markers could emerge if the consistency of neuropathy detection and reporting increases by the use of conventional standardized neuropathy assessment tools and grading scales.
Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This dose-limiting side-effect can diminish quality of life and, furthermore, cause discontinuation of vincristine treatment. The present review elucidates the current knowledge regarding vincristine-induced neuropathy in hematologic malignancies, focusing on neuropathy assessment, clinical and molecular predictive markers, drug-drug interference, prevention, and treatment.PURPOSEVincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This dose-limiting side-effect can diminish quality of life and, furthermore, cause discontinuation of vincristine treatment. The present review elucidates the current knowledge regarding vincristine-induced neuropathy in hematologic malignancies, focusing on neuropathy assessment, clinical and molecular predictive markers, drug-drug interference, prevention, and treatment.This review is conducted by a systematic search strategy for the identification of relevant literature in the PubMed and Embase databases.METHODSThis review is conducted by a systematic search strategy for the identification of relevant literature in the PubMed and Embase databases.No clinical parameters displayed convincing potential as predictors of vincristine-induced neuropathy; however, preexisting neuropathy was consistently reported to be associated with an increased risk of neurotoxicity. In contrast, molecular markers, including polymorphisms in genes involved in the pharmacodynamics and pharmacokinetics of vincristine, displayed great potential as predictive markers of neuropathy incidence and severity. Furthermore, antifungal drugs, such as itraconazole and voriconazole, decrease the metabolism of vincristine and consequently lead to severe neuropathy when co-administered with vincristine, underscoring why fluconazole should be the antifungal drug of choice.RESULTSNo clinical parameters displayed convincing potential as predictors of vincristine-induced neuropathy; however, preexisting neuropathy was consistently reported to be associated with an increased risk of neurotoxicity. In contrast, molecular markers, including polymorphisms in genes involved in the pharmacodynamics and pharmacokinetics of vincristine, displayed great potential as predictive markers of neuropathy incidence and severity. Furthermore, antifungal drugs, such as itraconazole and voriconazole, decrease the metabolism of vincristine and consequently lead to severe neuropathy when co-administered with vincristine, underscoring why fluconazole should be the antifungal drug of choice.Reports from the 71 included studies clearly emphasize the lack of consistency in neuropathy assessment, grading systems, and reporting, making it difficult to interpret results between studies. Thus, truer clinical and molecular markers could emerge if the consistency of neuropathy detection and reporting increases by the use of conventional standardized neuropathy assessment tools and grading scales.CONCLUSIONReports from the 71 included studies clearly emphasize the lack of consistency in neuropathy assessment, grading systems, and reporting, making it difficult to interpret results between studies. Thus, truer clinical and molecular markers could emerge if the consistency of neuropathy detection and reporting increases by the use of conventional standardized neuropathy assessment tools and grading scales.
Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This dose-limiting side-effect can diminish quality of life and, furthermore, cause discontinuation of vincristine treatment. The present review elucidates the current knowledge regarding vincristine-induced neuropathy in hematologic malignancies, focusing on neuropathy assessment, clinical and molecular predictive markers, drug-drug interference, prevention, and treatment. This review is conducted by a systematic search strategy for the identification of relevant literature in the PubMed and Embase databases. No clinical parameters displayed convincing potential as predictors of vincristine-induced neuropathy; however, preexisting neuropathy was consistently reported to be associated with an increased risk of neurotoxicity. In contrast, molecular markers, including polymorphisms in genes involved in the pharmacodynamics and pharmacokinetics of vincristine, displayed great potential as predictive markers of neuropathy incidence and severity. Furthermore, antifungal drugs, such as itraconazole and voriconazole, decrease the metabolism of vincristine and consequently lead to severe neuropathy when co-administered with vincristine, underscoring why fluconazole should be the antifungal drug of choice. Reports from the 71 included studies clearly emphasize the lack of consistency in neuropathy assessment, grading systems, and reporting, making it difficult to interpret results between studies. Thus, truer clinical and molecular markers could emerge if the consistency of neuropathy detection and reporting increases by the use of conventional standardized neuropathy assessment tools and grading scales.
Author Madsen, Marie Lindhard
Jensen, Paw
Ejskjær, Niels
Madsen, Jakob
Due, Hanne
Dybkær, Karen
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  givenname: Marie Lindhard
  surname: Madsen
  fullname: Madsen, Marie Lindhard
  organization: Department of Hematology, Aalborg University Hospital
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  surname: Due
  fullname: Due, Hanne
  organization: Department of Hematology, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University
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  givenname: Niels
  surname: Ejskjær
  fullname: Ejskjær, Niels
  organization: Department of Clinical Medicine, Aalborg University, Steno Diabetes Center North Denmark, Aalborg University Hospital
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  givenname: Paw
  surname: Jensen
  fullname: Jensen, Paw
  organization: Department of Hematology, Aalborg University Hospital, Clinical Cancer Research Center, Aalborg University Hospital
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  surname: Madsen
  fullname: Madsen, Jakob
  organization: Department of Hematology, Aalborg University Hospital
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  email: k.dybkaer@rn.dk
  organization: Department of Hematology, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Clinical Cancer Research Center, Aalborg University Hospital
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31214762$$D View this record in MEDLINE/PubMed
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Copyright The Author(s) 2019
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Issue 3
Keywords Biomarkers
Vincristine-induced neuropathy
Neurotoxicity
Hematologic malignancies
Vincristine
Language English
License Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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PublicationTitle Cancer chemotherapy and pharmacology
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Snippet Purpose Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive...
Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced...
PurposeVincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive...
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StartPage 471
SubjectTerms Antineoplastic Agents, Phytogenic - adverse effects
Autonomic nervous system
Blood cancer
Cancer Research
Central nervous system
Drug-Related Side Effects and Adverse Reactions - etiology
Drug-Related Side Effects and Adverse Reactions - pathology
Fluconazole
Hematologic Neoplasms - drug therapy
Hematologic Neoplasms - pathology
Humans
Itraconazole
Medicine
Medicine & Public Health
Neurotoxicity
Neurotoxicity Syndromes - etiology
Neurotoxicity Syndromes - pathology
Oncology
Peripheral neuropathy
Pharmacodynamics
Pharmacokinetics
Pharmacology/Toxicology
Prognosis
Quality of life
Review
Review Article
Reviews
Vincristine
Vincristine - adverse effects
Voriconazole
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Title Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review
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