Mirogabalin vs pregabalin for chemotherapy-induced peripheral neuropathy in pancreatic cancer patients

BMC Cancer. 2021 Dec 9;21(1):1319. doi: 10.1186/s12885-021-09069-9.

Abstract

Background: The prognosis of pancreatic cancer (PC) has been improved by new chemotherapy regimens (combination of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin (FOLFIRINOX) or gemcitabine plus nab-paclitaxel (GnP)). Unfortunately, chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse event of these two regimens. The efficacy of pregabalin for CIPN has been reported in previous studies. However, the efficacy of mirogabalin for CIPN remains unknown. Thus, in this study, we aimed to clarify which drug (mirogabalin or pregabalin) was more valuable for improving CIPN.

Methods: A total of 163 PC patients who underwent FOLFIRINOX or GnP between May 2014 and January 2021 were enrolled. Among them, 34 patients were diagnosed with CIPN. Thirteen patients were treated with mirogabalin (mirogabalin group), and twenty-one patients were treated with pregabalin (pregabalin group). Treatment efficacy was compared between the two groups.

Results: In both the mirogabalin group and the pregabalin group, the grade of patients with CIPN at 2, 4, and 6 weeks after the initiation of treatment showed significant improvement compared to the pretreatment grade. Notably, the rate of CIPN improvement was higher in the mirogabalin group than in the pregabalin group (2 weeks: 84.6% (11/13) vs 33.3% (7/21), P value = 0.005; 4 weeks, 6 weeks: 92.3% (12/13) vs 33.3% (7/21), P value = 0.001).

Conclusions: Although both mirogabalin and pregabalin were effective at improving CIPN, mirogabalin might be a suitable first choice for CIPN in PC patients.

Trial registration: Not applicable.

Keywords: chemotherapy-induced peripheral neuropathy; mirogabalin; pancreatic cancer; pregabalin.

MeSH terms

  • Aged
  • Analgesics / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bridged Bicyclo Compounds / therapeutic use*
  • Drug-Related Side Effects and Adverse Reactions / drug therapy*
  • Female
  • Fluorouracil / adverse effects
  • Fluorouracil / therapeutic use
  • Humans
  • Irinotecan / adverse effects
  • Irinotecan / therapeutic use
  • Leucovorin / adverse effects
  • Leucovorin / therapeutic use
  • Male
  • Middle Aged
  • Oxaliplatin / adverse effects
  • Oxaliplatin / therapeutic use
  • Pancreatic Neoplasms* / complications
  • Pancreatic Neoplasms* / drug therapy
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / drug therapy
  • Pregabalin / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Analgesics
  • Antineoplastic Agents
  • Bridged Bicyclo Compounds
  • folfirinox
  • Oxaliplatin
  • Pregabalin
  • Irinotecan
  • Leucovorin
  • mirogabalin
  • Fluorouracil