TY - JOUR
T1 - Vincristine-induced peripheral neuropathy in pediatric oncology
T2 - A randomized controlled trial comparing push injections with one-hour infusions (the vinca trial)
AU - van de Velde, Mirjam Esther
AU - Kaspers, Gertjan J.L.
AU - Abbink, Floor C.H.
AU - Twisk, Jos W.R.
AU - van der Sluis, Inge M.
AU - van den Bos, Cor
AU - van den Heuvel-Eibrink, Marry M.
AU - Segers, Heidi
AU - Chantrain, Christophe
AU - Bosch, Jutte van der Werff Ten
AU - Willems, Leen
AU - van den Berg, Marleen H.
N1 - Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/12
Y1 - 2020/12
N2 - Vincristine (VCR) is a frequently used chemotherapeutic agent. However, it can lead to VCR-induced peripheral neuropathy (VIPN). In this study we investigated if one-hour infusions of VCR instead of push-injections reduces VIPN in pediatric oncology patients. We conducted a multicenter randomized controlled trial in which participants received all VCR administrations through push injections or one-hour infusions. VIPN was measured at baseline and 1–5 times during treatment using Common Terminology Criteria of Adverse Events (CTCAE) and pediatric-modified Total Neuropathy Score. Moreover, data on co-medication, such as azole antifungals, were collected. Overall, results showed no effect of administration duration on total CTCAE score or ped-mTNS score. However, total CTCAE score was significantly lower in patients receiving one-hour infusions concurrently treated with azole antifungal therapy (β = −1.58; p = 0.04). In conclusion, generally VCR administration through one-hour infusions does not lead to less VIPN compared to VCR push injections in pediatric oncology patients. However, one-hour infusions lead to less severe VIPN compared to push-injections when azole therapy is administered concurrently with VCR. These results indicate that in children treated with VCR and requiring concurrent azole therapy, one-hour infusions might be beneficial over push injections, although larger trials are needed to confirm this association.
AB - Vincristine (VCR) is a frequently used chemotherapeutic agent. However, it can lead to VCR-induced peripheral neuropathy (VIPN). In this study we investigated if one-hour infusions of VCR instead of push-injections reduces VIPN in pediatric oncology patients. We conducted a multicenter randomized controlled trial in which participants received all VCR administrations through push injections or one-hour infusions. VIPN was measured at baseline and 1–5 times during treatment using Common Terminology Criteria of Adverse Events (CTCAE) and pediatric-modified Total Neuropathy Score. Moreover, data on co-medication, such as azole antifungals, were collected. Overall, results showed no effect of administration duration on total CTCAE score or ped-mTNS score. However, total CTCAE score was significantly lower in patients receiving one-hour infusions concurrently treated with azole antifungal therapy (β = −1.58; p = 0.04). In conclusion, generally VCR administration through one-hour infusions does not lead to less VIPN compared to VCR push injections in pediatric oncology patients. However, one-hour infusions lead to less severe VIPN compared to push-injections when azole therapy is administered concurrently with VCR. These results indicate that in children treated with VCR and requiring concurrent azole therapy, one-hour infusions might be beneficial over push injections, although larger trials are needed to confirm this association.
KW - Administration duration
KW - Adolescent
KW - Cancer
KW - Chemotherapeutic
KW - Children
KW - Exposure
KW - Infusion rate
KW - Neurotoxicity
KW - Oncovin
KW - Toxicity
KW - Vincristine
UR - http://www.scopus.com/inward/record.url?scp=85097808337&partnerID=8YFLogxK
U2 - 10.3390/cancers12123745
DO - 10.3390/cancers12123745
M3 - Article
AN - SCOPUS:85097808337
VL - 12
SP - 1
EP - 13
JO - Cancers
JF - Cancers
IS - 12
M1 - 3745
ER -