Calcium and Magnesium Infusions Reduce Oxaliplatin-Associated Neurotoxicity in CRC Patients

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(ChemotherapyAdvisor) – Administration of calcium and magnesium is associated with lower rates of oxaliplatin-induced neurotoxicity among patients with colorectal cancer (CRC), report authors of a meta-analysis published in the Annals of Oncology.

Ca/Mg administration tends to decrease “acute and cumulative neurotoxicity and thus enhance patients' tolerance to oxaliplatin, without significantly altering the efficacy of chemotherapy,” reported lead author Q. Li, Department of Medical Oncology, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan, People's Republic of China, and colleagues.

Oxaliplatin is used as an adjuvant and palliative CRC therapy, but neurotoxicity associated with impaired neuronal metabolism in dorsal root ganglia is a significant factor in dose modification and discontinuation.

Early studies have suggested that Ca/Mg infusions might reduce the incidence of oxaliplatin-associated neurotoxicity, but their use is controversial because of evidence they diminish chemotherapeutic efficacy. The new study's authors pooled data from 4 prospective randomized clinical trials and 3 retrospective studies, representing a total of 1,170 CRC patients: 368 controls and 802 patients who received Ca/Mg infusions. Their meta-analysis found significantly lower grade 3 neurotoxicity associated with oxaliplatin therapy in patients receiving calcium and magnesium.

“According to the National Cancer Institute-Common Terminology Criteria for Adverse Events, the incidence of grade 3 acute neurotoxicity in those who received Ca/Mg was significantly lower than that of the control group (OR = 0.26; 95% confidence interval (CI), 0.11–0.62; P = 0.0002),” the authors reported.

Ca/Mg-administered patients tended to receive a higher number of chemotherapy doses (P = 0.05) than those who did not receive Ca/Mg, but no significant differences were identified for median progression-free survival or median overall survival. 



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