Infusional 5-FU/FA plus Oxaliplatin (FUFOX) vs. Capecitabine plus Oxaliplatin (CAPOX)
Journal of Physical Chemistry - Longdom · a useful preventive method for oxaliplatin-induced...
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Volume 2 • Issue 1 • 1000e101 J Physic Chem Biophysic ISSN:2161-0398 JPCB an open access journal Open Access Editorial Yoshida, J Physic Chem Biophysic 2012, 2:1 DOI: 10.4172/2161-0398.1000e101 Keywords: Oxaliplatin; pH; Dexamethasone; Hypersensitivity reaction; Chemotherapy Oxaliplatin, a platinum-based chemotherapeutic agent, has showed marked efficacy for the treatment of advanced colorectal cancer [1,2]. Chemotherapy for colorectal cancer has advanced remarkably with the introduction of folinic acid, fluorouracil, and irinotecan (FOLFIRI); and folinic acid, fluorouracil, and oxaliplatin (FOLFOX); therapies, which require a central venous (CV) port. With the recent development of capecitabine plus oxaliplatin (XELOX) therapy, capecitabine plus irinotecan (XELIRI) therapy and irinotecan plus S-1 (IRIS) therapy involving oral administration of drug preparations, etc., implantation of a CV port can be now avoided. However, vascular pain occasionally requires switching of the drip infusion route during XELOX therapy by the administration of oxaliplatin via the peripheral vein. Vascular pain and phlebitis induced by intravenous infusion of antineoplastic agents reduces the completion or continuation of chemotherapy. e causative factors of vascular pain and phlebitis include the pH and osmotic pressure of the solution, size of the vein used, size and material of the catheter, and infusion periods [3]. A number of methods for avoiding phlebitis have been reported [4,5]; however, none of them are completely effective. us, there is an urgent need to develop new methods to prevent and alleviate phlebitis. 5% glucose in water containing oxaliplatin had a pH of approximately 4.78 [6]. Many patients have experienced adverse effects such as phlebitis and venous pain, which have proved to be related to an unphysiologically low solution pH. Kuwahara et al., [7] reported that phlebitis was less likely when the solution of Plas-amino was neutralized to pH 5.93 when given to rabbits, and was nearly eliminated when the pH was increased further to 6.49 [7]. us, the tolerance pH for the peripheral vein is about 6.5, i.e. an infusion solution does not cause phlebitis due to acidity if the pH is not lower than the tolerance pH. Some investigators reported that addition of steroids to oxaliplatin drip infusion is useful in controlling vascular pain [8]. However, the pharmacological use of steroids can make oxaliplatin unstable due to the elevation of pH; further, the effectiveness of oxaliplatin in this therapy is unknown because of lack of published data in this regard. e kinetics of the alkaline hydrolysis of oxaliplatin has been evaluated. Even though, at *Corresponding author: Yoichiro Yoshida, Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan, Tel: +81-92-801-1011; Fax: +81-92-863-9759; E-mail: [email protected] Received March 07, 2012; Accepted March 09, 2012; Published March 13, 2012 Citation: Yoshida Y (2012) Oxaliplatin and pH. J Physic Chem Biophysic 2:e101. doi:10.4172/2161-0398.1000e101 Copyright: © 2012 Yoshida Y. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Oxaliplatin and pH Yoichiro Yoshida* Department of Gastroenterological Surgery, Fukuoka University, Japan pH 7.4, the intermediate only constitutes a minor fraction (maximally 0.7%) of the oxaliplatin concentration, it might rapidly react with essential endogenous compounds resulting in a continuous conversion of oxaliplatin to its monodentate form [9]. We recently reported that the effectiveness of dexamethasone (DEX) for controlling vascular pain caused by the administration of oxaliplatin via the peripheral vein during XELOX therapy [6]. Furthermore, we found that co-infusion of DEX to oxaliplatin may be a useful preventive method for oxaliplatin-induced hypersensitivity. However, further studies will be needed to determine the efficacy of this method. References 1. de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, et al. (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18: 2938-2947. 2. Tournigand C, Andre T, Achille E, Lledo G, Flesh M, et al. (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 22: 229-237. 3. Kuwahara T, Asanami S, Kubo S (1998) Experimental infusion phlebitis: tolerance osmolality of peripheral venous endothelial cells. Nutrition 14: 496- 501. 4. Nakayama S, Matsubara N, Sakai T, Aso N (2002) The incidence of phlebitis in the patients administrated vinorelbine by intravenous bolus injection--a retrospective study. Gan To Kagaku Ryoho 29: 633-635. 5. Curran CF, Luce JK, Page JA (1990) Doxorubicin-associated flare reactions. Oncol Nurs Forum 17: 387-389. 6. Yoshida Y, Hoshino S, Aisu N, Shiwaku H, Beppu R, et al. (2012) Dexamethasone as a means not only for controlling vascular pain caused by the administration of oxalioplatin via the peripheral vein but also for controlling oxaliplatin-induced hypersensitivity reactions. Br J Med Med Res 2: 132-141. 7. Kuwahara T, Asanami S, Kawauchi Y, Kubo S (1999) Experimental infusion phlebitis: Tolerance pH of peripheral vein. J Toxicol Sci 24: 113-121. 8. Matsuyama K, Mishima H, Ueno H, Kajihara K, Morioka A, et al. (2011) Etiology and management of venous pain during intravenous administration of oxaliplatin. Gan To Kagaku Ryoho 38: 411-414. 9. Jerremalm E, Eksborg S, Ehrsson H (2003) Hydrolysis of oxaliplatin-evaluation of the acid dissociation constant for the oxalato monodentate complex. J Pharm Sci 92: 436-438. Journal of Physical Chemistry & Biophysics J o u r n a l o f P h y s i c a l C h e m i s t r y & B i o p h y s i c s ISSN: 2161-0398
Transcript of Journal of Physical Chemistry - Longdom · a useful preventive method for oxaliplatin-induced...
Research Article Open Access
Volume 2 • Issue 1 • 1000e101J Physic Chem BiophysicISSN:2161-0398 JPCB an open access journal
Open AccessEditorial
Yoshida, J Physic Chem Biophysic 2012, 2:1 DOI: 10.4172/2161-0398.1000e101
Keywords: Oxaliplatin; pH; Dexamethasone; Hypersensitivity reaction; Chemotherapy
Oxaliplatin, a platinum-based chemotherapeutic agent, has showed marked efficacy for the treatment of advanced colorectal cancer [1,2]. Chemotherapy for colorectal cancer has advanced remarkably with the introduction of folinic acid, fluorouracil, and irinotecan (FOLFIRI); and folinic acid, fluorouracil, and oxaliplatin (FOLFOX); therapies, which require a central venous (CV) port. With the recent development of capecitabine plus oxaliplatin (XELOX) therapy, capecitabine plus irinotecan (XELIRI) therapy and irinotecan plus S-1 (IRIS) therapy involving oral administration of drug preparations, etc., implantation of a CV port can be now avoided. However, vascular pain occasionally requires switching of the drip infusion route during XELOX therapy by the administration of oxaliplatin via the peripheral vein.
Vascular pain and phlebitis induced by intravenous infusion of antineoplastic agents reduces the completion or continuation of chemotherapy. The causative factors of vascular pain and phlebitis include the pH and osmotic pressure of the solution, size of the vein used, size and material of the catheter, and infusion periods [3]. A number of methods for avoiding phlebitis have been reported [4,5]; however, none of them are completely effective. Thus, there is an urgent need to develop new methods to prevent and alleviate phlebitis. 5% glucose in water containing oxaliplatin had a pH of approximately 4.78 [6]. Many patients have experienced adverse effects such as phlebitis and venous pain, which have proved to be related to an unphysiologically low solution pH. Kuwahara et al., [7] reported that phlebitis was less likely when the solution of Plas-amino was neutralized to pH 5.93 when given to rabbits, and was nearly eliminated when the pH was increased further to 6.49 [7]. Thus, the tolerance pH for the peripheral vein is about 6.5, i.e. an infusion solution does not cause phlebitis due to acidity if the pH is not lower than the tolerance pH. Some investigators reported that addition of steroids to oxaliplatin drip infusion is useful in controlling vascular pain [8]. However, the pharmacological use of steroids can make oxaliplatin unstable due to the elevation of pH; further, the effectiveness of oxaliplatin in this therapy is unknown because of lack of published data in this regard. The kinetics of the alkaline hydrolysis of oxaliplatin has been evaluated. Even though, at
*Corresponding author: Yoichiro Yoshida, Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan, Tel: +81-92-801-1011; Fax: +81-92-863-9759; E-mail: [email protected]
Received March 07, 2012; Accepted March 09, 2012; Published March 13, 2012
Citation: Yoshida Y (2012) Oxaliplatin and pH. J Physic Chem Biophysic 2:e101. doi:10.4172/2161-0398.1000e101
Copyright: © 2012 Yoshida Y. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Oxaliplatin and pHYoichiro Yoshida*
Department of Gastroenterological Surgery, Fukuoka University, Japan
pH 7.4, the intermediate only constitutes a minor fraction (maximally 0.7%) of the oxaliplatin concentration, it might rapidly react with essential endogenous compounds resulting in a continuous conversion of oxaliplatin to its monodentate form [9].
We recently reported that the effectiveness of dexamethasone (DEX) for controlling vascular pain caused by the administration of oxaliplatin via the peripheral vein during XELOX therapy [6]. Furthermore, we found that co-infusion of DEX to oxaliplatin may be a useful preventive method for oxaliplatin-induced hypersensitivity.However, further studies will be needed to determine the efficacy of this method.
References
1. de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, et al. (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18: 2938-2947.
2. Tournigand C, Andre T, Achille E, Lledo G, Flesh M, et al. (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 22: 229-237.
3. Kuwahara T, Asanami S, Kubo S (1998) Experimental infusion phlebitis: tolerance osmolality of peripheral venous endothelial cells. Nutrition 14: 496-501.
4. Nakayama S, Matsubara N, Sakai T, Aso N (2002) The incidence of phlebitis in the patients administrated vinorelbine by intravenous bolus injection--a retrospective study. Gan To Kagaku Ryoho 29: 633-635.
5. Curran CF, Luce JK, Page JA (1990) Doxorubicin-associated flare reactions. Oncol Nurs Forum 17: 387-389.
6. Yoshida Y, Hoshino S, Aisu N, Shiwaku H, Beppu R, et al. (2012) Dexamethasone as a means not only for controlling vascular pain caused by the administration of oxalioplatin via the peripheral vein but also for controlling oxaliplatin-induced hypersensitivity reactions. Br J Med Med Res 2: 132-141.
7. Kuwahara T, Asanami S, Kawauchi Y, Kubo S (1999) Experimental infusion phlebitis: Tolerance pH of peripheral vein. J Toxicol Sci 24: 113-121.
8. Matsuyama K, Mishima H, Ueno H, Kajihara K, Morioka A, et al. (2011) Etiology and management of venous pain during intravenous administration of oxaliplatin. Gan To Kagaku Ryoho 38: 411-414.
9. Jerremalm E, Eksborg S, Ehrsson H (2003) Hydrolysis of oxaliplatin-evaluation of the acid dissociation constant for the oxalato monodentate complex. J Pharm Sci 92: 436-438.
Journal of Physical Chemistry & BiophysicsJo
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ISSN: 2161-0398
