Study on efficacy and safety of Huangqi Guizhi Wuwu decoction treatment for oxaliplatin induced peripheral neurotoxicity: A protocol for a randomized, controlled, double-blind, multicenter trial

Xiao-Man Wei, Xiao-Feng Chen, Peng Shu, Zhi-Wei Jiang, Xiao-Yu Wu, Xi Zou, Kai Chen, Bo Shen, Wen-Wei Hu, Wei Lu, Wei-Xing Shen, Liu Li, Jun-Yi Wang, Feng-Jiao Zhao, Qing-Feng Yin, Hai-Bo Cheng, Yan-Hong Gu, Xiao-Man Wei, Xiao-Feng Chen, Peng Shu, Zhi-Wei Jiang, Xiao-Yu Wu, Xi Zou, Kai Chen, Bo Shen, Wen-Wei Hu, Wei Lu, Wei-Xing Shen, Liu Li, Jun-Yi Wang, Feng-Jiao Zhao, Qing-Feng Yin, Hai-Bo Cheng, Yan-Hong Gu

Abstract

Background: Oxaliplatin can cause severe peripheral neurotoxicity, which is an important reason for clinical oxaliplatin reduction and cessation of treatment. Oxaliplatin induced peripheral neurotoxicity (OIPN) can cause paresthesia and dysesthesia, even affect the quality life of patients. So far, there are no recognized and effective measures to prevent OIPN. Huangqi Guizhi Wuwu decoction is a classical prescription of ancient Chinese medicine recorded in "the synopsis of the Golden Chamber," which can be used in the treatment of various neurotoxicity. However, there is a lack of large-scale and high-quality clinical studies on the prevention of OIPN by Huangqi Guizhi Wuwu decoction. The purpose of this study is to evaluate the efficacy and safety of Huangqi Guizhi Wuwu decoction on preventing OIPN.

Methods/design: This study is a randomized, controlled, double-blind, and multicenter clinical trial. Three hundred sixty patients will be randomly assigned into Huangqi Guizhi Wuwu decoction group and Huangqi Guizhi Wuwu decoction mimetic agent group. Patients will receive chemotherapy with FOLFOX of 8 cycles of 3 weeks with Traditional Chinese Medicine (TCM) for 6 months and 1-year follow-up. The primary outcome measure is the differences in the incidence of chronic neurotoxicity of grade 2 and above during and after treatment. The secondary outcome measure is the improvement in other symptoms associated with chemotherapy. Four methods will be used to evaluate the efficacy of neurotoxicity, including oxaliplatin specific toxicity grading standard (Levi classification); CTCAE4.02 version; EORTC QLQ-CIPN20 scale, EORTC QLQ C30 scale, and EORTC QLQ-CR29 scale are used at the same time; Electromyography.

Discussion: This study will provide objective evidences to evaluate the efficacy and safety of Huangqi Guizhi Wuwu Decoction on preventing OIPN.

Trial registration: Clinical Trials.gov (Identifier: NCT04261920).

References

    1. Kweekel DM, Gelderblom H, Guchelaar##HJ. Pharmacology of oxaliplatin and the use of pharmacogenomics to individualize therapy. Cancer Treat Rev 2005;31:90–105.
    1. Extra JM, Marty M, Brienza S, et al. Pharmacokinetics and safety profile of oxaliplatin. Semin Oncol 1998;25: (2 suppl 5): 13–22.
    1. Lehky TJ, Leonard GD, Wilson RH, et al. Oxaliplatin-induced neurotoxicity: acute hyperexcitability and chronic neuropathy. Muscle Nerve 2004;29:387–92.
    1. Wilson RH, et al. Acute oxaliplatin-induced peripheral nerve hyperexcitability. J Clin Oncol 2002;20:1767–74.
    1. Argyriou AA, et al. A review on oxaliplatin-induced peripheral nerve damage. Cancer Treat Rev 2008;34:368–77.
    1. Andre T, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 2004;350:2343–51.
    1. Hershman DL, Lacchetti C, Dworkin RH, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 2014;32:1941–67.
    1. Su Y, Huang J, Wang S, et al. The effects of Ganglioside-Monosialic Acid in Taxane-induced peripheral neurotoxicity in patients with breast cancer: a randomized trial. J Natl Cancer Inst 2020;112:55–62.
    1. De Gramont A. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 2000;18:2938–47.
    1. Hartmann JT, Lipp HP. Toxicity of platinum compounds. Expert Opin Pharmacother 2003;4:889–901.
    1. Cavaletti G, Marmiroli P. Chemotherapy-induced peripheral neurotoxicity. Lancet Oncol 2004;10:535–46.
    1. Avan A, Postma TJ, Ceresa C, et al. Platinum-induced neurotoxicity and preventive strategies: past, present, and future. Oncologist 2015;20:411–32.
    1. Albers JW, Chaudhry V, Cavaletti G, et al. Interventions for preventing neuropathy caused by cisplatin and related compounds. Cochrane Database Syst Rev 2011;CD005228.
    1. Fei L. Formulae of Traditional Chinese Medicine. 2017;Beijing: People's Medical Publishing House, 685–88.
    1. Jun T, Xue-Quan Y, Xiao-Yu WU, et al. Systematic review and meta analysis on efficacy of Huangqi Guizhi Wuwu decoction for oxaliplatin-induced peripheral neurotoxicity. Chin J Exp Tradit Med Formulae 2013;19:325–30.
    1. Xiaoman L. The anti-oxidant effect of Huangqiguizhiwuwu decoction on oxaliplatin induced peripheral neuropathy. Nanjing Univ Chin Med 2016;1–37.
    1. Fei W, Yuehua W. The observation of modified Huangqi Guizhi Wuwu Decoction on prevention and treatment for Oxaliplatin induced acute peripheral neurotoxicity. Clin J Trad Chin Med 2012;24:319–20.
    1. Cheng X, Huo J, Wang D, et al. Herbal medicine AC591 prevents oxaliplatin-induced peripheral neuropathy in animal model and cancer patients. Front Pharmacol 2017;8:344.

Source: PubMed

3
订阅