The Relief of Nociceptive Pain Induced by Panitumumab Could be Sustainable during Chemotherapy
DOI:
https://doi.org/10.30683/1927-7229.2024.13.09Keywords:
Panitumumab, cancer-related pain, pain relief, nociceptive pain, visceral pain, somatic pain, neuropathic pain, colorectal cancerAbstract
Anti-epidermal growth factor receptor (EGFR) antibodies and tyrosine kinase inhibitors, which are molecular-targeted drugs used in cancer treatment, are suspected to have analgesic effects on cancer-related pain. The relieving effect of EGFR inhibitors on neuropathic pain has been described to persist for approximately 20 days in patients with colorectal cancer. Since the administration of panitumumab, ananti-EGFR antibody, is repeated every 14 days, its relieving effect on cancer-related pain should be maintained until the next administration. To test this hypothesis, we investigated the chronological changes in symptoms before and two and 14 days after administration. A retrospective study using electrical patient charts demonstrated that the analgesic effects of panitumumab sustained in 8 out of ten patients with colorectal cancer (80%) until the start of next cycle of chemotherapy. The relief of nociceptive pain can be maintained in most of the patients during chemotherapy by repeated use of this agent, once pain relief has been achieved.
References
Douillard JY, Siena S, Cassidy J, et al. Randomized phase III trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as first line treatment in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2010; 28: 4697-705. https://doi.org/10.1200/JCO.2009.27.4860
Martin LJ, Smith SB, Khoutorsky A, et al. Epiregulin and EGFR interactions are involved in pain processing. J Clin Invest 2017; 127: 3353-66. https://doi.org/10.1172/JCI87406
Verma V, Khoury S, Parisien M, et al. The dichomatous role of epiregulin in pain. Pain 2020; 161: 1052-64. https://doi.org/10.1097/j.pain.0000000000001792
Hirsh V, Cadranel J, Cong XJ, et al. Symptom and quality of life benefit of afatinib in advanced non-small-cell lung cancer patients previously treated with erlotinib or gefitinib: results of a randomized phase IIb/III trial (LUX-Lung 1). J Thorac Oncol 2013; 8: 229-37. https://doi.org/10.1097/JTO.0b013e3182773fce
Kersten C, Cameron MG, Laird B, Mjaland S. Epidermal growth factor receptor-inhibition (EGFR-I) in the treatment of neuropathic pain. Br J Anaesthesia 2015; 115: 761-767. https://doi.org/10.1093/bja/aev326
Kersten C, Cameron MG, Bailey AG, et al. Relief of neuropathic pain through epidermal growth factor receptor inhibition: A randomized proof-of-concept trial. Pain Med 2019; 20: 2495-2505. https://doi.org/10.1093/pm/pnz101
Kersten C, Cameronb MG. Cetuximab alleviates neuropathic pain despite tumour progression. BMJ Case Reports 2012. pii: bcr1220115374. https://doi.org/10.1136/bcr.12.2011.5374
Yuasa S, Kabeya M, Furuta R, et al. A case of sigmoid colon cancer in which somatic pain was rapidly alleviated after panitumumab administration despite tumor progression. J Anal Oncol 2016; 5: 38-41. https://doi.org/10.6000/1927-7229.2016.05.01.5
Yuasa S, Kabeya M, Furuta R, et al, Retrospective comparison of changes in cancer pain and chronic peripheral neuropathy induced by oxaliplatin before and after administration of panitumumab and bevacizumab. J Anal Oncol, 2022; 11: 40-44. https://doi.org/10.30683/1927-7229.2022.11.06
Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature 2001; 413: 203-10. https://doi.org/10.1038/35093019
Borges JP, Mekhail K, Fairn GD, Antonescu CN, Steinberg BE. Modulation of pathological pain by epidermal growth factor receptor. Front Pharmacol 2021; 12: 642820. https://doi.org/10.3389/fphar.2021.642820
Zhuang ZY, Gerner P, Woolf C, Ji RR. ERK is sequentially activated in neurons, microglia, and astrocytes by spinal nerve ligation and contributes to mechanical allodynia in this neuropathic pain model. Pain 2005; 114: 149-59. https://doi.org/10.1016/j.pain.2004.12.022
Puig S, Donica CL, Gutstein HB. EGFR signaling causes morphine tolerance and mechanical sensitization in rats. eNeuro. 2020; 7: ENEURO.0460-18.2020. https://doi.org/10.1523/ENEURO.0460-18.2020
Santi MD, Zhang M, Liu N, et al. Repurposing EGFR inhibitors for oral cancer pain and opioid tolerance. Pharmaceuticals (Basel) 2023; 16: 1558. https://doi.org/10.3390/ph16111558
Cameron MG, Kersten C. Prospective case series of neuropathic cancer pain in patients treated with an EGFR-inhibitor. Palliative Medicine 2022; 36: 1154-1162. https://doi.org/10.1177/02692163221102003
Japanese society for palliative medicine, Clinical guideline for cancer pain management third edition 2020, pp22-26, Kanehara & Co. Ltd, Tokyo Japan.
Ries DJ, Cullum RL. Epiregulin: roles in normal physiology and cancer. Semin Cell Dev Biol 2014; 28: 49-56. https://doi.org/10.1016/j.semcdb.2014.03.005
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Similar Articles
- Mervat Mahrous, Tasabeeh Mohamed, Ghassan Al SISI, Ahmed Al-Hujaily, Samira AlSumani, Primary Squamous Cell Carcinoma of the Breast is a Rare and Special Entity , Journal of Analytical Oncology: Vol. 7 No. 3 (2018)
- Ahmad Salimi, Mehrnoush Pir Saharkhiz, Abbasali Motallebi, Enayatollah Seydi, Ali Reza Mohseni, Melika Nazemi , Jalal Pourahmad, Standardized Extract of the Persian Gulf Sponge, Axinella Sinoxea Selectively Induces Apoptosis through Mitochondria in Human Chronic Lymphocytic Leukemia Cells , Journal of Analytical Oncology: Vol. 4 No. 4 (2015)
- Kanupriya Gupta, T.P. Chaturvedi, Jatin Gupta, Glypicans - A Brief Review , Journal of Analytical Oncology: Vol. 8 (2019)
- Wenyong Tan, Ming Yang, Yong Dai, Desheng Hu, Geometric Changes in the Parotid, Submandibular, and Thyroid Glands during Intensity Modulated Radiotherapy for Nasopharyngeal Carcinoma: A Cohort Study , Journal of Analytical Oncology: Vol. 9 (2020)
- Krishnendu Ghosh, Jayanta Kumar Chandra, Anirban Ghosh, Brain Tumour Classification by Machine Learning Applications with Selected Biological Features: Towards A Newer Diagnostic Regime , Journal of Analytical Oncology: Vol. 9 (2020)
- Patrik Simko, Terezia Kiskova, Uncovering the Anticancer Potential of Lichen Secondary Metabolites , Journal of Analytical Oncology: Vol. 11 (2022)
- Sergio Vázquez, María José Villanueva, José Luis Fírvida, Begoña Campos, Martín Lázaro, Gerardo Huidobro, María del Carmen Areses, Natalia Fernández, Marta Covela , Joaquín Casal, Erlotinib as Second-Line Therapy for Patients with Advanced Non-Small-Cell Lung Cancer and Wild-Type EGFR Tumors , Journal of Analytical Oncology: Vol. 4 No. 3 (2015)
- Sajad Ahmad Salati, Lamees Alsulaim, Ajaz A Rather, Paget’s Disease of the Breast (PDB) – A Review , Journal of Analytical Oncology: Vol. 11 (2022)
- James H. Tabibian, Keith D. Lindor, Challenges of Cholangiocarcinoma Detection in Patients with Primary Sclerosing Cholangitis , Journal of Analytical Oncology: Vol. 1 No. 1 (2012)
- Neeti Sharma, Editorial: Epithelial – to - Mesenchymal Transition in Cancer , Journal of Analytical Oncology: Vol. 4 No. 4 (2015)
You may also start an advanced similarity search for this article.
Most read articles by the same author(s)
- Shu Yuasa, Megumi Kabeya, Satoshi Hibi, Yuko Shirokawa, Chiaki Tokoro, Ryuichi Furuta, Seiji Nagao, Satoshi Kayukawa, Yoshiteru Tanaka, Kenji Ina, Retrospective Evaluation of the Analgesic Effects of Molecular Target Agents Against Cancer Pain and Oxaliplatin-Induced Chronic Peripheral Neuropathy , Journal of Analytical Oncology: Vol. 11 (2022)
- Satoshi Hibi, Yuko Shirokawa, Kengo Nanya, Yuko Kato, Nobuto Ito, Takae Kataoka, Takashi Yoshida, Yoshiaki Marumo, Satoshi Kayukawa, Shu Yuasa, Yoshiteru Tanaka, Kenji Ina, Application of the Plan-Do-Check-Act Cycle for Managing Immune-Related Adverse Events , Journal of Analytical Oncology: Vol. 10 (2021)