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Pain descriptors of taxane acute pain syndrome (TAPS) in breast cancer patients—a prospective clinical study

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Abstract

Background

Taxane acute pain syndrome (TAPS) is a clinically significant side-effect of taxane chemotherapy, often described as arthralgia and myalgia that occurs 2–3 days after infusion. The aim of this study was to assess pain descriptors used by patients during their experience of TAPS.

Methods

A clinical prospective cohort study was conducted on breast cancer patients who had not received prior chemotherapy and were asked to complete diaries on three consecutive docetaxel treatment cycles on days 1–7, 14, and 21 (acute phase). Questionnaires to assess pain severity, descriptors of pain, and the interference in activities due to pain were adapted from the Brief Pain Inventory and the McGill Pain Questionnaire. Telephone questionnaire follow-up was done at 1, 3, 6, 9, and 12 months following docetaxel (delayed phase).

Results

The most commonly used descriptor for acute and chronic pain was “aching” (90–96%). However, in the delayed phase of the study, “burning” (32–50%), “radiating” (39–48%), and “sharp” (40–69%) were used more often. In both acute and chronic pain phases, most patients experienced moderate/severe pain regardless of the location. Pain in cycle 1 was predictive of pain in subsequent taxane cycles (p < 0.0001). Pain in cycle 3 was predictive of chronic pain (p < 0.002).

Conclusions

The descriptors used by patients experiencing chemotherapy-induced pain (ChIP) may be reflective of the underlying mechanisms. It is suspected that TAPS initiates as an acute inflammatory pain, which over time develops into neuropathic pain, known as chemotherapy-induced peripheral neuropathy (CIPN). However, the subjective pain experience varies from patient to patient.

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References

  1. Fernandes R, Mazzarello S, Hutton B, Shorr R, Majeed H, Ibrahim MFK, Jacobs C, Ong M, Clemons M (2016) Taxane acute pain syndrome (TAPS) in patients receiving taxane-based chemotherapy for breast cancer—a systematic review. Support Care Cancer 24(8):3633–3650. https://doi.org/10.1007/s00520-016-3256-5

    Article  PubMed  Google Scholar 

  2. Addington J, Freimer M (2016) Chemotherapy-induced peripheral neuropathy: an update on the current understanding. F1000Research 5:1466. https://doi.org/10.12688/f1000research.8053.1

    Article  CAS  Google Scholar 

  3. Shinde SS, Seisler D, Soori G, Atherton PJ, Pachman DR, Lafky J, Ruddy KJ, Loprinzi CL (2016) Can pregabalin prevent paclitaxel-associated neuropathy - an ACCRU pilot trial. Support Care Cancer 24(2):547–553. https://doi.org/10.1007/s00520-015-2807-5

    Article  PubMed  Google Scholar 

  4. Chiu N, Zhang L, Dent R, Giotis A, van Draanen J, Gallo-Hershberg D, Chiu L, Chow R, Wan BA, Pasetka M, Stinson J, Stacey E, Verma S, Lam H, Chow E, DeAngelis C (2018) A prospective study of docetaxel-associated pain syndrome. Support Care Cancer 26(1):203–211. https://doi.org/10.1007/s00520-017-3836-z

    Article  PubMed  Google Scholar 

  5. Fernandes R, Mazzarello S, Hutton B, Shorr R, Ibrahim MFK, Jacobs C et al (2016) A systematic review of the incidence and risk factors for taxane acute pain syndrome in patients receiving taxane-based chemotherapy for prostate cancer. Clin Genitourin Cancer 15(1):1–6. https://doi.org/10.1016/j.clgc.2016.07.018

    Article  PubMed  Google Scholar 

  6. Chiu N, Chiu L, Chow R, Lam H, Verma S, Pasetka M, Chow E, DeAngelis C (2017) Taxane-induced arthralgia and myalgia: a literature review. J Oncol Pharm Pract 23(1):56–67. https://doi.org/10.1177/1078155215627502

    Article  PubMed  CAS  Google Scholar 

  7. Song SJ, Min J, Suh SY, Jung SH, Hahn HJ, Im SA, Lee JY (2017) Incidence of taxane-induced peripheral neuropathy receiving treatment and prescription patterns in patients with breast cancer. Support Care Cancer 25(7):2241–2248. https://doi.org/10.1007/s00520-017-3631-x

    Article  PubMed  Google Scholar 

  8. Hellerstedt-Börjesson S, Nordin K, Fjällskog M-L, Holmström IK, Arving C (2015) Women with breast cancer experience of chemotherapy-induced pain: triangulation of methods. Cancer Nurs 38(1):31–39. https://doi.org/10.1097/NCC.0000000000000124

    Article  PubMed  Google Scholar 

  9. Davis LL, Carpenter JS, Otte JL (2016) State of the science: taxane-induced musculoskeletal pain. Cancer Nurs 39(3):187–196. https://doi.org/10.1097/NCC.0000000000000273

    Article  PubMed  Google Scholar 

  10. Persohn E, Canta A, Schoepfer S, Traebert M, Mueller L, Gilardini A, Galbiati S, Nicolini G, Scuteri A, Lanzani F, Giussani G, Cavaletti G (2005) Morphological and morphometric analysis of paclitaxel and docetaxel-induced peripheral neuropathy in rats. Eur J Cancer 41(10):1460–1466. https://doi.org/10.1016/j.ejca.2005.04.006

    Article  PubMed  CAS  Google Scholar 

  11. Lambertini M, Del Mastro L, Bellodi A, Pronzato P (2014) The five “Ws” for bone pain due to the administration of granulocyte-colony stimulating factors (G-CSFs). Crit Rev Oncol Hematol 89(1):112–128. https://doi.org/10.1016/j.critrevonc.2013.08.006

    Article  PubMed  Google Scholar 

  12. Melzac R (1975) The McGill pain questionnaire: major properties and scoring methods. Pain 1(3):277–299

    Article  Google Scholar 

  13. Cleeland CS, Ryan KM (1994) Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap 23(2):129–138

    PubMed  CAS  Google Scholar 

  14. Cleeland C (2009) The Brief Pain Inventory (BPI). In: The brief pain inventory user guide. The Brief Pain Inventory. https://doi.org/10.1016/j.jphys.2015.07.001

    Chapter  Google Scholar 

  15. Stüve O, Zettl U (2014) Neuroinflammation of the central and peripheral nervous system: an update. Clin Exp Immunol 175(3):333–335. https://doi.org/10.1111/cei.12260

    Article  PubMed  PubMed Central  Google Scholar 

  16. Loprinzi CL, Maddocks-Christianson K, Wolf SL, Rao RD, Dyck PJB, Mantyh P, Dyck PJ (2007) The paclitaxel acute pain syndrome: sensitization of nociceptors as the putative mechanism. Cancer J 13(6):399–403. https://doi.org/10.1097/PPO.0b013e31815a999b

    Article  PubMed  Google Scholar 

  17. Thakral M, Shi L, Foust JB, Patel KV, Shmerling RH, Bean JF, Leveille SG (2016) Pain quality descriptors in community-dwelling older adults with nonmalignant pain. Pain 157(12):2834–2842. https://doi.org/10.1097/j.pain.0000000000000719

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lin CP, Kupper AE, Gammaitoni AR, Galer BS, Jensen MP (2011) Frequency of chronic pain descriptors: implications for assessment of pain quality. Eur J Pain 15(6):628–633. https://doi.org/10.1016/j.ejpain.2010.11.006

    Article  PubMed  Google Scholar 

  19. Arning K, Baron R (2009) Evaluation of symptom heterogeneity in neuropathic pain using assessments of sensory functions. Neurotherapeutics 6(4):738–748. https://doi.org/10.1016/j.nurt.2009.07.002

    Article  PubMed  PubMed Central  Google Scholar 

  20. Baron R, Tolle TR (2008) Assessment and diagnosis of neuropathic pain. Current Opinion in Supportive and Palliative Care 2(1):1–8

    Article  Google Scholar 

  21. Mystakidou K, Parpa E, Tsilika E, Pathiaki M, Galanos A, Vlahos L (2007) Comparison of pain quality descriptors in cancer patients with nociceptive and neuropathic pain. In Vivo 21(1):93–98. https://doi.org/10.1016/S0885-3924(01)00351-7

    Article  PubMed  Google Scholar 

  22. Loprinzi CL, Reeves BN, Dakhil SR, Sloan JA, Wolf SL, Burger KN, Kamal A, le-Lindqwister NA, Soori GS, Jaslowski AJ, Novotny PJ, Lachance DH (2011) Natural history of paclitaxel-associated acute pain syndrome: prospective cohort study NCCTG N08C1. J Clin Oncol 29(11):1472–1478. https://doi.org/10.1200/JCO.2010.33.0308

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Finnerup NB, Norrbrink C, Trok K, Piehl F, Johannesen IL, Sørensen JC, Jensen TS, Werhagen L (2014) Phenotypes and predictors of pain following traumatic spinal cord injury: a prospective study. J Pain 15(1):40–48. https://doi.org/10.1016/j.jpain.2013.09.008

    Article  PubMed  Google Scholar 

  24. Gibbs GF, Drummond PD, Finch PM, Phillips JK (2008) Unravelling the pathophysiology of complex regional pain syndrome: focus on sympathetically maintained pain. Clin Exp Pharmacol Physiol 35(7):717–724. https://doi.org/10.1111/j.1440-1681.2007.04862.x

    Article  PubMed  CAS  Google Scholar 

  25. Boureau F, Doubrere JF, Luu M (1990) Study of verbal description in neuropathic pain. Pain 42(2):145–152. https://doi.org/10.1016/0304-3959(90)91158-F

    Article  PubMed  CAS  Google Scholar 

  26. Wilkie DJ, Molokie R, Boyd-Seal D, Suarez ML, Kim YO, Zong S, Wittert H, Zhao Z, Saunthararajah Y, Wang ZJ (2010) Patient-reported outcomes: descriptors of nociceptive and neuropathic pain and barriers to effective pain management in adult outpatients with sickle cell disease. J Natl Med Assoc 102(1):18–27. https://doi.org/10.1016/S0027-9684(15)30471-5

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kramer BJ, Harker JO, Wong AL (2002) Descriptions of joint pain by American Indians: comparison of inflammatory and noninflammatory arthritis. Arthritis Rheum 47(2):149–154. https://doi.org/10.1002/art1.10325

    Article  PubMed  Google Scholar 

  28. Epstein JB, Wilkie DJ, Fischer DJ, Kim Y-O, Villines D (2009) Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy. Head & Neck Oncology 1(1):26–38. https://doi.org/10.1186/1758-3284-1-26

    Article  Google Scholar 

  29. Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A, Jafari-Schluep H, Lantéri-Minet M, Laurent B, Mick G, Serrie A, Valade D, Vicaut E (2005) Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114(1–2):29–36. https://doi.org/10.1016/j.pain.2004.12.010

    Article  PubMed  Google Scholar 

  30. Butler S, Jonzon B, Branting-Ekenback C, Wadell C, Farahmand B (2013) Predictors of severe pain in a cohort of 5271 individuals with self-reported neuropathic pain. Pain 154(1):141–146. https://doi.org/10.1016/j.pain.2012.10.001

    Article  PubMed  Google Scholar 

  31. Wilkie DJ, Huang H-Y, Reilly NL, Cain KC (2001) Nociceptive and neuropathic pain in patients with lung cancer: a comparison of pain quality descriptors. J Pain Symptom Manag 22(5):899–910

    Article  CAS  Google Scholar 

  32. Backonja MM, Stacey B (2004) Neuropathic pain symptoms relative to overall pain rating. J Pain 5(9):491–497. https://doi.org/10.1016/j.jpain.2004.09.001

    Article  PubMed  Google Scholar 

  33. Rasmussen PV, Sindrup SH, Jensen TS, Bach FW (2004) Symptoms and signs in patients with suspected neuropathic pain. Pain 110:461–469. https://doi.org/10.1016/j.pain.2004.04.034

    Article  PubMed  Google Scholar 

  34. Freeman R, Baron R, Bouhassira D, Cabrera J, Emir B (2014) Sensory profiles of patients with neuropathic pain based on the neuropathic pain symptoms and signs. Pain 155(2):367–376. https://doi.org/10.1016/j.pain.2013.10.023

    Article  PubMed  Google Scholar 

  35. Tofthagen CS, McMillan SC (2010) Pain, neuropathic symptoms, and physical and mental well-being in persons with cancer. Cancer Nurs 33(6):436–444. https://doi.org/10.1097/NCC.0b013e3181e212b4.Pain

    Article  PubMed  PubMed Central  Google Scholar 

  36. Makker PGS, Duffy SS, Lees JG, Perera CJ, Tonkin RS, Butovsky O, Park SB, Goldstein D, Moalem-Taylor G (2017) Characterisation of immune and neuroinflammatory changes associated with chemotherapy-induced peripheral neuropathy. PLoS One 12(1):1–24. https://doi.org/10.1371/journal.pone.0170814

    Article  CAS  Google Scholar 

  37. Chiu N, Zhang L, Gallo-Hershberg D, Dent R, Chiu L, Pasetka M, van Draanen J, Chow R, Lam H, Verma S, Stinson J, Stacey E, Chow E, DeAngelis C (2016) Which pain intensity scale from the brief pain inventory correlates most highly with functional interference scores in patients experiencing taxane-induced arthralgia and myalgia? Support Care Cancer 24(7):2979–2988. https://doi.org/10.1007/s00520-016-3106-5

    Article  PubMed  Google Scholar 

  38. Zheng FY, Xiao WH, Bennett GJ (2011) The response of spinal microglia to chemotherapy-evoked painful peripheral neuropathies is distinct from that evoked by traumatic nerve injuries. Neuroscience 176:447–454. https://doi.org/10.1016/j.neuroscience.2010.12.052

    Article  PubMed  CAS  Google Scholar 

  39. Ren K, Dubner R (2010) Interactions between the immune and nervous systems in pain. Nat Med 16(11):1267–1276. https://doi.org/10.1038/nm.2234

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  40. Ueda H (2006) Molecular mechanisms of neuropathic pain-phenotypic switch and initiation mechanisms. Pharmacol Ther 109(1–2):57–77. https://doi.org/10.1016/j.pharmthera.2005.06.003

    Article  PubMed  CAS  Google Scholar 

  41. Dahl JB, Møiniche S (2004) Pre-emptive analgesia. Br Med Bull 71(December):13–27. https://doi.org/10.1093/bmb/ldh030

    Article  PubMed  Google Scholar 

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Funding

We thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Joey and Mary Furfari Cancer Research Fund, Pulenzas Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund. The funding sources were not involved in the study design, data collection, analyses and interpretation of the data, manuscript writing, and the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Pharmacy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada

    Rashi Asthana PhD Student, Liying Zhang PhD, Bo Angela Wan, Angie Giotis BSc Pharm, Mark Pasetka PharmD, Shannon Goodall, Patrick L. Diaz PhD, Leah Drost, Edward Chow MBBS, M.Sc., PhD, FRCPC & Carlo De Angelis PharmD

  2. Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario, M5S 3M2, Canada

    Rashi Asthana PhD Student, Daniela Gallo-Hershberg PharmD & Carlo De Angelis PharmD

  3. Cancer Care Ontario 620 University Ave, Toronto, Ontario, M5G 2L7, Canada

    Daniela Gallo-Hershberg PharmD

  4. Department of Sociology, University of British Columbia Vancouver Campus, 6303 NW Marine Drive, Vancouver, British Colombia, V6T 1Z1, Canada

    Jenna van Draanen PhD

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  1. Rashi Asthana PhD Student
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Contributions

Conception and design: Carlo De Angelis, Edward Chow, Daniela Gallo-Hershberg, Angie Giotis, Jenna van Draanen.

Data management: Daniela Gallo-Hershberg, Angie Giotis, Jenna van Draanen, Shannon Goodall.

Analysis and interpretation: Carlo De Angelis, Rashi Asthana, Liying Zhang.

Drafting of the article: Rashi Asthana, Bo Angela Wan, Patrick Diaz.

Revision of the article: all authors.

Final approval of the version: all authors.

Agreement to be accountable for all aspects of the work: all authors.

Corresponding author

Correspondence to Carlo De Angelis PharmD.

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Asthana, R., Zhang, L., Wan, B.A. et al. Pain descriptors of taxane acute pain syndrome (TAPS) in breast cancer patients—a prospective clinical study. Support Care Cancer 28, 589–598 (2020). https://doi.org/10.1007/s00520-019-04845-7

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