Featured Publications
Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy
Molassiotis A, Cheng H, Lopez V, Au J, Chan A, Bandla A, Leung K, Li Y, Wong K, Suen L, Chan C, Yorke J, Farrell C, Sundar R. Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy. BMC Cancer 2019, 19: 132. PMID: 30736741, PMCID: PMC6368751, DOI: 10.1186/s12885-019-5302-4.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsCohort StudiesDose-Response Relationship, DrugFemaleHumansLongitudinal StudiesMaleMiddle AgedNeoplasm StagingNeoplasmsPatient Reported Outcome MeasuresPeripheral Nervous System DiseasesPrevalenceProspective StudiesQuality of LifeSeverity of Illness IndexConceptsChemotherapy-induced peripheral neuropathyPeripheral neuropathyNeurotoxic chemotherapyPrevalence of sensory neuropathyCohort study of patientsCumulative chemotherapy dosePlatinum-based chemotherapyLongitudinal cohort study of patientsMeasuring chemotherapy-induced peripheral neuropathyStudy of patientsNerve conduction studiesAssessment of chemotherapy-induced peripheral neuropathyCIPN incidencePatient-reported outcome measuresAssociated with onsetLongitudinal cohort studyChemotherapy doseMotor neurotoxicityClinician-based scalesMotor neuropathySensory neuropathyChemotherapyNeuropathyNatural historyPatients
2024
A phase Ib/II study of an anti-CD137 agonist antibody ADG106 in combination with weekly paclitaxel and dose-dense doxorubicin/cyclophosphamide.
Lee M, Ow S, Wong A, Lim S, Lim J, Soo R, Cheng Ean C, Tan D, Yong W, Chan G, Ho J, Sooi K, Low Q, Ang C, Cheo S, Sundar R, Goh B, Lee S. A phase Ib/II study of an anti-CD137 agonist antibody ADG106 in combination with weekly paclitaxel and dose-dense doxorubicin/cyclophosphamide. Journal Of Clinical Oncology 2024, 42: e14507-e14507. DOI: 10.1200/jco.2024.42.16_suppl.e14507.Peer-Reviewed Original ResearchAdverse eventsG3 neutropeniaTumor biopsiesWeekly PPeripheral neuropathyHER2 negative breast cancer patientsPhase IbDose levelsRecommended phase 2 doseAll-grade adverse eventsNegative breast cancer patientsMatched tumor biopsiesPhase 2 doseTumor immune markersPneumocystis jiroveci pneumoniaAdvanced solid tumorsPalliative systemic therapyPhase Ib trialPhase II trialPhase IISerial tumor biopsiesBreast cancer patientsIgG4 monoclonal antibodyAcneiform rashAnti-CD137
2022
The phenotype and value of nerve conduction studies in measuring chemotherapy-induced peripheral neuropathy: A secondary analysis of pooled data
Wang M, Bandla A, Sundar R, Molassiotis A. The phenotype and value of nerve conduction studies in measuring chemotherapy-induced peripheral neuropathy: A secondary analysis of pooled data. European Journal Of Oncology Nursing 2022, 60: 102196. PMID: 36067640, DOI: 10.1016/j.ejon.2022.102196.Peer-Reviewed Original ResearchConceptsChemotherapy-induced peripheral neuropathyMeasuring chemotherapy-induced peripheral neuropathyNerve conduction studiesQuality of lifePeripheral neuropathySecondary analysisSecondary analysis of pooled dataPerformance of nerve conduction studiesNerve conduction study resultsNerve conduction study parametersTime points of assessmentInitiation of chemotherapyPatient-reported symptomsOxaliplatin-based chemotherapyPooled dataClinical examination outcomeAnalysis of pooled dataConduction studiesCIPN assessmentMonitoring peripheral neuropathyNeurotoxic chemotherapyProspective studyClinical examinationSensory nervesChemotherapyPrevention of Oxaliplatin-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis
Peng S, Ying A, Chan N, Sundar R, Soon Y, Bandla A. Prevention of Oxaliplatin-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis. Frontiers In Oncology 2022, 12: 731223. PMID: 35186722, PMCID: PMC8853097, DOI: 10.3389/fonc.2022.731223.Peer-Reviewed Original ResearchOxaliplatin-induced peripheral neuropathyNon-pharmacological interventionsChronic oxaliplatin-induced peripheral neuropathyMeta-analysisSystematic reviewPrevent oxaliplatin-induced peripheral neuropathyGrading of RecommendationsPreventive measuresPooled risk ratioQuality of lifeRandomized controlled trialsPrimary outcome measureRandom-effects modelDatabases PubMed-MEDLINENetwork meta-analysisPreventive interventionsOutcome measuresNo interventionPubMed-MedlinePeripheral neuropathyClinical impactRisk ratioControlled trialsCancer patientsConfidence intervalsA Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy
Leen A, Yap D, Teo C, Tan B, Molassiotis A, Ishiguro H, Fan S, Sundar R, Soon Y, Bandla A. A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy. Frontiers In Oncology 2022, 11: 763229. PMID: 35070969, PMCID: PMC8766304, DOI: 10.3389/fonc.2021.763229.Peer-Reviewed Original ResearchPaclitaxel-induced peripheral neuropathyPeripheral neuropathyTreatment arm compared to controlsMeta-analysisPooled resultsNeuroprotective interventionsSide effects of paclitaxelEffects of paclitaxelDisabling side effectsEffect of neuroprotectionNon-pharmacological interventionsNon-pharmacological trialsRelevant controlled trialsNon-pharmacological approachesRandom-effects modelEffective prevention strategiesBiomedical Literature DatabasePrimary outcomePharmacological trialsModerate heterogeneityPrevention strategiesPharmacological interventionsSystematic reviewLiterature databasesIntervention
2021
Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis
Jia J, Guo Y, Sundar R, Bandla A, Hao Z. Cryotherapy for Prevention of Taxane-Induced Peripheral Neuropathy: A Meta-Analysis. Frontiers In Oncology 2021, 11: 781812. PMID: 34912720, PMCID: PMC8667340, DOI: 10.3389/fonc.2021.781812.Peer-Reviewed Original ResearchTaxane-induced peripheral neuropathyCommon Terminology Criteria for Adverse EventsChemotherapy-induced peripheral neuropathyPeripheral neuropathyDose reductionMeta-analysisSensory neuropathyIncidence of taxane-induced peripheral neuropathyIncidence of sensory neuropathyPrevent chemotherapy-induced peripheral neuropathyLimits chemotherapy doseEfficacy of cryotherapyIncidence of motorAssociated with reduced incidenceQuality of lifeNerve conduction studiesMeta-Analysis softwareReduce patients' qualityGynecological cancer therapyNeuropathy questionnaireChemotherapy doseClinical guidelinesMotor neuropathyAdverse eventsClinical evidence
2020
A Limb Hypothermia Wearable for Chemotherapy-Induced Peripheral Neuropathy: A Mixed-Methods Approach in Medical Product Development
Binder J, Unver E, Clayton J, Burke P, Paxman R, Sundar R, Bandla A. A Limb Hypothermia Wearable for Chemotherapy-Induced Peripheral Neuropathy: A Mixed-Methods Approach in Medical Product Development. Frontiers In Digital Health 2020, 2: 573234. PMID: 34713046, PMCID: PMC8521967, DOI: 10.3389/fdgth.2020.573234.Peer-Reviewed Original ResearchChemotherapy-induced peripheral neuropathyPeripheral neuropathyDose-limiting side effectTaxane-based chemotherapyLarge-scale efficacy trialsChemotherapy-induced alopeciaPrevention of chemotherapy-induced alopeciaHigh-risk natureMixed-methods approachIntegration of evidence-basedCIPN severityClinical trialsDevice designDesign inputsEfficacy trialsChemotherapyScalp coolingMultidisciplinary approachEvidence-based approachNeuropathyExpert focus groupEarly dataMedical device designAdditive manufacturingLimb Hypothermia for the Prevention of Chemotherapy-Induced Peripheral Neuropathy – Modality for Optimal Cooling
Bandla A, Santhanakrishnan P, Magarajah G, Vaidya G, Subramanian A, Wei H, Wilder-Smith E, Chin L, Thakor N, Sundar R. Limb Hypothermia for the Prevention of Chemotherapy-Induced Peripheral Neuropathy – Modality for Optimal Cooling. Annual International Conference Of The IEEE Engineering In Medicine And Biology Society (EMBC) 2020, 00: 5061-5064. PMID: 33019124, DOI: 10.1109/embc44109.2020.9175432.Peer-Reviewed Original ResearchConceptsChemotherapy-induced peripheral neuropathyPrevent chemotherapy-induced peripheral neuropathyFrozen glovesLimb hypothermiaHealthy subjectsPrevention of chemotherapy-induced peripheral neuropathyDose-limiting adverse effectsReduce chemotherapy-induced peripheral neuropathyNeurotoxic chemotherapeutic agentsNo adverse eventsTransient erythemaSafety profileAdverse eventsChemotherapeutic agentsPeripheral neuropathyCancer patientsClinical trialsOrthopaedic indicationsClinical utilityHypothermiaSports injuriesCooling modalitiesModalitiesSkin temperatureCryocompressionConcomitant limb cryocompression and scalp cooling to reduce paclitaxel-induced neuropathy and alopecia.
Sundar R, Magarajah G, Ow S, Chan G, Choo J, Eng L, Wong A, Vijayan J, Hairom Z, Ang E, Paxman R, Wilder-Smith E, Thakor N, Lee S, Bandla A. Concomitant limb cryocompression and scalp cooling to reduce paclitaxel-induced neuropathy and alopecia. Journal Of Clinical Oncology 2020, 38: e24157-e24157. DOI: 10.1200/jco.2020.38.15_suppl.e24157.Peer-Reviewed Original ResearchChemotherapy-induced peripheral neuropathyPaclitaxel-induced neuropathyChemotherapy-induced alopeciaPost-chemotherapyScalp coolingAdverse effects of paclitaxelPreservation of nerve functionWeekly paclitaxel chemotherapyToxicity of paclitaxelEffects of paclitaxelReducing chemotherapy-induced alopeciaBreast cancer patientsLimb hypothermiaProof-of-concept studyPaclitaxel chemotherapyHypothermia trialTransient erythemaNo significant differencePatient toleranceRandomized studyNerve functionPre-chemotherapyPeripheral neuropathyChemotherapyCancer patientsActivation of sphingosine 1-phosphate receptor 2 attenuates chemotherapy-induced neuropathy
Wang W, Xiang P, Chew W, Torta F, Bandla A, Lopez V, Seow W, Lam B, Chang J, Wong P, Chayaburakul K, Ong W, Wenk M, Sundar R, Herr D. Activation of sphingosine 1-phosphate receptor 2 attenuates chemotherapy-induced neuropathy. Journal Of Biological Chemistry 2020, 295: 1143-1152. DOI: 10.1016/s0021-9258(17)49922-4.Peer-Reviewed Original ResearchChemotherapy-induced neuropathyRat model of cisplatin-induced neuropathyManagement of chemotherapy-induced neuropathyTreatment of chemotherapy-induced neuropathyS1P speciesEffects of platinum-based drugsCisplatin-induced neuropathyPlasma S1P levelsDorsal root gangliaHuman cancer patientsActivating stress-response proteinsPlatinum-based drugsSphingosine 1-phosphateReduced allodyniaS1P1 signalingOxaliplatin treatmentPharmacodynamic analysisPeripheral neuropathyRat modelCancer patientsLipid-based signaling moleculesS1P concentrationsS1P levelsCYM-5478Platinum-based therapeutics
2019
Activation of sphingosine 1-phosphate receptor 2 attenuates chemotherapy-induced neuropathy
Wang W, Xiang P, Chew W, Torta F, Bandla A, Lopez V, Seow W, Lam B, Chang J, Wong P, Chayaburakul K, Ong W, Wenk M, Sundar R, Herr D. Activation of sphingosine 1-phosphate receptor 2 attenuates chemotherapy-induced neuropathy. Journal Of Biological Chemistry 2019, 295: 1143-1152. PMID: 31882542, PMCID: PMC6983853, DOI: 10.1074/jbc.ra119.011699.Peer-Reviewed Original ResearchConceptsChemotherapy-induced neuropathyRat model of cisplatin-induced neuropathyManagement of chemotherapy-induced neuropathyTreatment of chemotherapy-induced neuropathyS1P speciesEffects of platinum-based drugsCisplatin-induced neuropathyPlasma S1P levelsDorsal root gangliaS1P<sub>1-5</sub>Human cancer patientsActivating stress-response proteinsPlatinum-based drugsReduced allodyniaSphingosine 1-phosphateOxaliplatin treatmentPharmacodynamic analysisPeripheral neuropathyRat modelS1PCancer patientsLipid-based signaling moleculesS1P concentrationsS1P levelsCYM-5478Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy
Bandla A, Tan S, Kumarakulasinghe N, Huang Y, Ang S, Magarajah G, Hairom Z, Lim J, Wong A, Chan G, Ngoi N, Ang E, Lee Y, Chan A, Lee S, Thakor N, Wilder-Smith E, Sundar R. Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy. Supportive Care In Cancer 2019, 28: 3691-3699. PMID: 31811482, PMCID: PMC7316694, DOI: 10.1007/s00520-019-05177-2.Peer-Reviewed Original ResearchConceptsNerve conduction studiesTotal Neuropathy ScoreFrozen glovesTaxane chemotherapyNeuropathy scorePeripheral neuropathyDose-limiting toxicityConcomitant with chemotherapyTaxane-induced peripheral neuropathySeverity of neuropathySensory nerve amplitudesPrevention of neurotoxicitySkin temperature reductionLimb hypothermiaMonths post-chemotherapyPaclitaxel chemotherapyNerve amplitudeMotor amplitudeSevere neuropathyPost-chemotherapyUndesired side effectsChemotherapyCancer patientsNeuropathySide effectsRedefining chemotherapy-induced peripheral neuropathy through symptom cluster analysis and patient-reported outcome data over time
Wang M, Cheng H, Lopez V, Sundar R, Yorke J, Molassiotis A. Redefining chemotherapy-induced peripheral neuropathy through symptom cluster analysis and patient-reported outcome data over time. BMC Cancer 2019, 19: 1151. PMID: 31775665, PMCID: PMC6882224, DOI: 10.1186/s12885-019-6352-3.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsCluster AnalysisFemaleHumansLongitudinal StudiesMaleMiddle AgedNeoplasm StagingNeoplasmsPatient Reported Outcome MeasuresPeripheral Nervous System DiseasesPublic Health SurveillanceQuality of LifeSurveys and QuestionnairesSymptom AssessmentConceptsSymptom clustersCancer Quality of Life Questionnaire CoreTreatment of Cancer Quality of Life Questionnaire CoreQuality of Life Questionnaire CoreImprove symptom managementPatient-reported outcome dataBackgroundChemotherapy-induced peripheral neuropathySymptom management strategiesMethodsA secondary analysisSymptom cluster analysisNeurotoxic chemotherapy agentsEuropean Organization for the ResearchSymptom managementChemotherapy-induced peripheral neuropathySecondary analysisResultsSample sizeCancer diagnosisAssessment pointsPeripheral neuropathyOutcome dataCIPNClinical practiceThe ResearchFollow-upSecondary symptomsRisk factors for chemotherapy‐induced peripheral neuropathy in patients receiving taxane‐ and platinum‐based chemotherapy
Molassiotis A, Cheng H, Leung K, Li Y, Wong K, Au J, Sundar R, Chan A, De Ng T, Suen L, Chan C, Yorke J, Lopez V. Risk factors for chemotherapy‐induced peripheral neuropathy in patients receiving taxane‐ and platinum‐based chemotherapy. Brain And Behavior 2019, 9: e01312. PMID: 31063261, PMCID: PMC6576180, DOI: 10.1002/brb3.1312.Peer-Reviewed Original ResearchConceptsChemotherapy-induced peripheral neuropathyDevelopment of chemotherapy-induced peripheral neuropathyHistory of neuropathyRisk factorsPeripheral neuropathyPlatinum-based chemotherapySymptom burdenPotential risk factorsVegetable/fruit intakeWHO criteriaChemotherapy cyclesAlcohol intakeSmoking historyUnivariate analysisChemotherapyMultivariate regression modelMedical historyTreatment characteristicsNeurotoxic chemotherapyKey risk factorsNeuropathyCancer CenterSide effectsQuality of lifeTreatment decisionsMinimal clinically important difference of the EORTC QLQ-CIPN20 for worsening peripheral neuropathy in patients receiving neurotoxic chemotherapy
Yeo F, Ng C, Loh K, Molassiotis A, Cheng H, Au J, Leung K, Li Y, Wong K, Suen L, Chan C, Yorke J, Farrell C, Bandla A, Ang E, Lopez V, Sundar R, Chan A. Minimal clinically important difference of the EORTC QLQ-CIPN20 for worsening peripheral neuropathy in patients receiving neurotoxic chemotherapy. Supportive Care In Cancer 2019, 27: 4753-4762. PMID: 30972646, DOI: 10.1007/s00520-019-04771-8.Peer-Reviewed Original ResearchConceptsMinimal clinically important differenceEORTC QLQ-CIPN20QLQ-CIPN20Clinically important differenceDistribution-based approachMotor subscaleNtx subscaleConclusionThe MCIDChange scoresSensory subscaleFunctional Assessment of Cancer Therapy/Gynecologic Oncology Group-NeurotoxicityImportant differenceStandard error of measurementFACT/GOG-NtxNeurotoxic chemotherapyExperience of symptomsAnchor-based approachError of measurementEuropean Organisation of ResearchDistribution-based methodsPeripheral neuropathyChemotherapy-induced peripheral neuropathyMethodsCancer patientsCycles of chemotherapyWorsening peripheral neuropathy
2017
Limb Hypothermia for Preventing Paclitaxel-Induced Peripheral Neuropathy in Breast Cancer Patients: A Pilot Study
Sundar R, Bandla A, Tan S, Liao L, Kumarakulasinghe N, Jeyasekharan A, Ow S, Ho J, Tan D, Lim J, Vijayan J, Therimadasamy A, Hairom Z, Ang E, Ang S, Thakor N, Lee S, Wilder-Smith E. Limb Hypothermia for Preventing Paclitaxel-Induced Peripheral Neuropathy in Breast Cancer Patients: A Pilot Study. Frontiers In Oncology 2017, 6: 274. PMID: 28119855, PMCID: PMC5222823, DOI: 10.3389/fonc.2016.00274.Peer-Reviewed Original ResearchNerve conduction studiesBreast cancer patientsPeripheral neuropathyPaclitaxel infusionLimb hypothermiaPreventing paclitaxel-induced peripheral neuropathyCancer patientsPaclitaxel-induced peripheral neuropathyHistory of diabetes mellitusDose-limiting toxicityCompound muscle action potentialCool limbsMuscle action potentialWeekly paclitaxelSensory velocityDiabetes mellitusGrade 2Contralateral limbAction potentialsPaclitaxelPilot trialPatientsControl limbsHypothermiaTolerance to hypothermia
2016
Low Levels of NDRG1 in Nerve Tissue Are Predictive of Severe Paclitaxel-Induced Neuropathy
Sundar R, Jeyasekharan A, Pang B, Soong R, Kumarakulasinghe N, Ow S, Ho J, Lim J, Tan D, Wilder-Smith E, Bandla A, Tan S, Asuncion B, Fazreen Z, Hoppe M, Putti T, Poh L, Goh B, Lee S. Low Levels of NDRG1 in Nerve Tissue Are Predictive of Severe Paclitaxel-Induced Neuropathy. PLOS ONE 2016, 11: e0164319. PMID: 27716814, PMCID: PMC5055363, DOI: 10.1371/journal.pone.0164319.Peer-Reviewed Original ResearchConceptsPaclitaxel-induced neuropathySevere neuropathyReceiver operating characteristicNerve tissueDose-limiting toxicityEarly breast cancerSensory peripheral neuropathyArea under the curveBreast cancer patientsIntensity of stainingWeekly paclitaxelSurgical resectionCharcot-Marie-ToothLimiting toxicitiesPredictive biomarkersNerve biopsyPeripheral neuropathyBreast cancerBiomarker strategiesCancer patientsNDRG1 expressionNeuropathyExpression scorePatientsPaclitaxel
2014
Paclitaxel-induced severe sensory peripheral neuropathy is associated with NDRG-1 genetic variant and negative NDRG-1 expression in nerve tissue.
Sundar R, Jeyasekharan A, Tan K, Putti T, Poh L, Yap H, Sapari N, Soong R, Lee S. Paclitaxel-induced severe sensory peripheral neuropathy is associated with NDRG-1 genetic variant and negative NDRG-1 expression in nerve tissue. Journal Of Clinical Oncology 2014, 32: 1054-1054. DOI: 10.1200/jco.2014.32.15_suppl.1054.Peer-Reviewed Original Research