Key result
Nab-paclitaxel was associated with similar chronic neuropathy severity compared to paclitaxel, but oxaliplatin produced significantly more severe neuropathy, including reduced sural amplitude.
Why the study?
There remains limited evidence regarding the relative long-term neurotoxic potential of nab-paclitaxel.
Does nab-paclitaxel cause different severity of chemotherapy-induced peripheral neuropathy compared to paclitaxel or oxaliplatin in patients treated with chemotherapy?
Cross-Sectional (n=72)
Yes
Does nab-paclitaxel cause different severity of chemotherapy-induced peripheral neuropathy compared to paclitaxel or oxaliplatin in patients treated with chemotherapy?
Absolute Event Rate: 8.5% vs 4.5%
p-value: p=0.003
Nab-paclitaxel and paclitaxel have similar neurotoxic profiles, whereas oxaliplatin induces more severe peripheral neuropathy.
BACKGROUND AND PURPOSE: There remains limited evidence regarding the relative neurotoxic potential of nab-paclitaxel long-term. This cross-sectional matched cohort study aimed to compare the severity and natural history of chemotherapy-induced peripheral neuropathy (CIPN) between patients treated with nab-paclitaxel and patients treated with oxaliplatin or paclitaxel using a suite of clinical, patient reported, and neurophysiological assessments. PATIENTS AND METHODS: CIPN assessments included the total neuropathy score (TNSc), grooved pegboard assessment, sensory assessments (grating orientation task and Von-Frey assessment), patient-reported outcome measures, and neurophysiological studies. The matched cohort included 72 patients (24 nab-paclitaxel, 24 paclitaxel, and 24 oxaliplatin); each stratified into two groups by time post-treatment, 0-4 months, and > 6 months. RESULTS: Chronic neuropathy was reported by 71% of nab-paclitaxel-treated patients, most prominently numbness in the lower limbs. Longer time post-treatment was associated with significantly better TNSc scores (p = 0.044). Neuropathy severity was similar for nab-paclitaxel and paclitaxel. Neuropathy severity was worse for oxaliplatin compared to nab-paclitaxel, as measured by sensory function (p < 0.05) and sural amplitude (p = 0.003), but similar for patient-reported and neurological-graded assessments. INTERPRETATION: These findings underscore the importance of inclusion of a range of multimodal CIPN assessments to characterize relative burden of toxicity between chemotherapy agents. CIPN severity was similar between nab-paclitaxel and paclitaxel cohorts, but more severe in oxaliplatin-treated patients.
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Trinh et al. (2025) conducted a cross-sectional in Chemotherapy-induced peripheral neuropathy (n=72). Nab-paclitaxel vs. Paclitaxel and Oxaliplatin was evaluated on Sural nerve amplitude (µV) compared to oxaliplatin (p=0.003). Nab-paclitaxel was associated with similar chronic neuropathy severity compared to paclitaxel, but oxaliplatin produced significantly more severe neuropathy, including reduced sural amplitude.
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