N(2)-L-Alanyl-L-Glutamine Dipeptide Preventing Oxaliplatin-Induced Neurotoxicity in Colorectal Cancer Patients - Journal of Cancer Therapy

JCT > Vol.7 No.9, September 2016

N(2)-L-Alanyl-L-Glutamine Dipeptide Preventing Oxaliplatin-Induced Neurotoxicity in Colorectal Cancer Patients ()

HTML XML

Download as PDF (Size: 356KB) PP. 609-621

DOI: 10.4236/jct.2016.79064 2,284 Downloads 4,173 Views Citations

Author(s)

Adel Gabr¹, Ahmed A. S. Salem², Haisem Ahmed Samy³, Shimaa Tmam⁴, Anwar Mohammed Ali⁵

Affiliation(s)

¹Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
²Surgical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
³Diagnostic Radiology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
⁴Radiation Therapy Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
⁵Department of Neurophysiology, Faculty of Medicine, Assiut University, Assiut, Egypt.

ABSTRACT

Oxaliplatin and infusional fluorouracil/leucovorin or capecitabine has emerged as important options in the adjuvant and palliative treatment of colorectal cancer. Severe Oxaliplatin induced neurotoxicity may require chemotherapy dose reduction or cessation. The incidence of oxaliplatin-induced neurotoxicity has varied from 12% - 18%. Several attempts have been proposed to prevent or treat oxaliplatin-induced neurotoxicity, but treatment of established chronic Oxaliplatin induced neurotoxicity is limited. Purpose: To assess the efficacy of parenteral Glutamine dipeptide (N2-L-Alanyl-L-Glutamine Dipeptide, 20 g·m/100ml, IV) for preventing of oxaliplatin induced neurotoxicity. Patients and Methods: A pilot study was performed. 120 patients with metastatic colorectal cancer (mCRC) entered into the study. 60 patients randomly assigned to receive IV glutamine dipeptide (20 g·m IV) day 1-2 with FOLFOX-4 to be repeated every 15 days as a first line of treatment of metastatic colorectal cancer and 60 patients assigned to receive only FOLFOX-4 (control group). Neurotoxicity symptoms and signs were evaluated before each cycle. Results: There were significantly fewer neurological symptoms in patients receiving glutamine dipeptide than in those who did not. A decreased percentage of grade 1-2 peripheral neuropathy was observed in the glutamine dipeptide group after two cycles (8.3% versus 20%; P = 0.04) and 4 cycles (13.3% vs 26.7%; P = 0.02). A significantly lower incidence of grade 3-4 neuropathy was noted in the glutamine dipeptide group after four and six cycles (6.7% versus 15%, P = 0.02 and 13.3% versus 33.3%. P = 0.04, respectively). The need for oxaliplatin dose reduction was significantly lower in the glutamine dipeptide (Dipeptiven) group (10% vs 26.7%; P = 0.02) and there were no significant differences between two groups in response to chemotherapy among patient with mCRC (48.3% vs 50%). Conclusion: These data concluded that IV dipeptide glutamine significantly decreases the incidence and severity of oxaliplatin induced neurotoxicity of mCRC without any attendant side effects.

KEYWORDS

Colorectal Cancer, Oxaliplatin, FOLFOX-4, Alanylglutamine, Neuropathy

Share and Cite:

Gabr, A. , Salem, A. , Samy, H. , Tmam, S. and Ali, A. (2016) N(2)-L-Alanyl-L-Glutamine Dipeptide Preventing Oxaliplatin-Induced Neurotoxicity in Colorectal Cancer Patients. Journal of Cancer Therapy, 7, 609-621. doi: 10.4236/jct.2016.79064.

Journals Menu

Follow SCIRP

	+1 323-425-8868
	customer@scirp.org
	+86 18163351462(WhatsApp)
	1655362766

	Paper Publishing WeChat

Journals Menu

Home

About SCIRP

Service

Policies