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Risk factor analysis for taxane-associated acute pain syndrome under the dexamethasone prophylaxis

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Abstract

Purpose

Taxane-associated acute pain syndrome (T-APS) reportedly occurs in approximately 70% of patients undergoing therapy. We have previously reported that additional dexamethasone (DEX) administration attenuates T-APS. The aim of this study was to reveal risk factor(s) associated with the incidence of T-APS under prophylactic DEX administration.

Methods

In total, 143 patients with breast cancer who received docetaxel (75 mg/m2) or paclitaxel (175 mg/m2)-containing treatment regimens were enrolled. DEX (4–8 mg) was orally administered on days 2–4. Risk factors for the incidence of ≥ G2 and all-grade T-APS, as well as T-APS incidence between taxane-containing regimens in the first cycle, were retrospectively evaluated.

Results

Approximately 90% of the patients received taxanes for adjuvant or neoadjuvant chemotherapy. Overall, 55% of patients administered 4 mg DEX, whereas 45% received 8 mg DEX. Pegfilgrastim was administered in 27% of patients. Incidence of ≥ G2 and all-grade T-APS was 23.8%, and 69.2%, respectively. Univariate and multivariate analyses revealed that administration of pegfilgrastim is an independent risk factor for the incidence of ≥ G2 and all-grade T-APS; age younger than 55 years is also a risk factor for all-grade T-APS. Moreover, the incidence of ≥ G2 and all-grade T-APS was 45.5% and 81.8% in a paclitaxel regimen, and 22.0% and 68.2% in docetaxel-including regimens, respectively, revealing increased tendency with paclitaxel administration, with no significant differences.

Conclusion

Pegfilgrastim co-administration is an independent risk factor for ≥ G2 and all-grade T-APS, and age younger than 55 years is a risk factor of all-grade T-APS under prophylactic DEX administration.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Department of Pharmacy, Hokkaido University Hospital, Kita 14-jo, Nishi 5-chome, Kita-ku, Sapporo, 060-8648, Japan

    Yoshitaka Saito, Yoh Takekuma, Tatsuhiko Sakamoto & Mitsuru Sugawara

  2. Laboratory of Clinical Pharmaceutics & Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University, Kita 12-jo, Nishi 6-chome, Kita-ku, Sapporo, 060-0812, Japan

    Masaki Kobayashi

  3. Department of Breast Surgery, Hokkaido University Hospital, Kita 14-jo, Nishi 5-chome, Kita-ku, Sapporo, 060-8648, Japan

    Hiroko Yamashita

  4. Laboratory of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hokkaido University, Kita 12-jo, Nishi 6-chome, Kita-ku, Sapporo, 060-0812, Japan

    Mitsuru Sugawara

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Contributions

YS, TY, TS, and MK participated in research design. YS and TS conducted experiments. YS and TS performed data analysis. YS, TY, MK, TS, HY, and MS either wrote or contributed to the writing of the manuscript.

Corresponding author

Correspondence to Mitsuru Sugawara.

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Saito, Y., Takekuma, Y., Kobayashi, M. et al. Risk factor analysis for taxane-associated acute pain syndrome under the dexamethasone prophylaxis. Support Care Cancer 29, 8059–8067 (2021). https://doi.org/10.1007/s00520-021-06342-2

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  • DOI: https://doi.org/10.1007/s00520-021-06342-2

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