Optimisation of steroid prophylaxis schedules in breast cancer patients receiving docetaxel chemotherapy—a survey of health care providers and patients
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Despite the widespread use of steroid prophylaxis schedules for breast cancer patients receiving docetaxel chemotherapy, questions still exist regarding their optimal use. We surveyed health care providers and patients about their experiences with steroid prophylaxis.
Two questionnaires were developed and circulated. One was presented to health care providers (chemotherapy nurses, pharmacists and medical oncologists) involved in the treatment of breast cancer and the second to patients who had received docetaxel chemotherapy for early stage breast cancer.
The health care providers’ questionnaire was completed by 184 of 698 invitees: 92/171 (53.8 %) chemotherapy nurses, 56/284 (19.7 %) pharmacists and 36/243 (14.8 %) medical oncologists (overall response rate 26.4 %). Two steroid schedules were found to be the most commonly used: dexamethasone 8 mg BID for 6 doses, with either 3 (79 %) or 2 (11 %) doses taken before docetaxel administration. Suboptimal adherence to steroid premedication had been experienced by 98 % (177/181) of practitioners. Despite the presence of local treatment protocols in 65 % (119/183) of practitioners’ institutions, 10 different strategies were commonly used when steroid premedication was taken incorrectly. The patients’ questionnaire was completed by 72/87 (82.3 %) invitees. Respondents reported correctly taking their premedication 99 % (70/71) of the time. Patients felt steroids frequently caused side effects, the most common being sleep disturbance (35/72 = 49 %) and skin toxicity (16/72 = 22 %).
Suboptimal adherence to steroid premedication prior to docetaxel administration is a common clinical challenge. There appears to be discordance between the practitioner and the patient experience. A single, universally accepted and used protocol for both pre- and post-medication and management when premedication is not taken as prescribed could improve adherence.
KeywordsBreast cancer Docetaxel Corticosteroid Premedication
The authors wish to acknowledge Flay Charbonneau for her help with survey distribution.
Conflict of interest
BH has previously received consultancy fees and remuneration from Amgen Canada. All other authors have no conflicts of interest or disclosures to declare.
Compliance with ethical standards
This study was approved by the Ottawa Health Sciences Network Research Ethics Board, protocol number #20140027-01H. The study complies with the laws of the countries in which it was performed.
- 2.Cortes JE, Pazdur R (1995) Docetaxel. J Clin Oncol Off J Am Soc Clin Oncol 13(10):2643–2655Google Scholar
- 3.Semb KA, Aamdal S, Oian P (1998) Capillary protein leak syndrome appears to explain fluid retention in cancer patients who receive docetaxel treatment. J Clin Oncol Off J Am Soc Clin Oncol 16(10):3426–3432Google Scholar
- 5.Riva A FP, Roche H et al (1997) Efficacy and safety of different corticosteroid (C) premedications (P) in breast cancer (BC) patients (pts) treated with Taxotere (T). Proc Am Soc Clin Oncol 16:188a:Abstract 660Google Scholar
- 6.Piccart MJ, Klijn J, Paridaens R, Nooij M, Mauriac L, Coleman R, Bontenbal M, Awada A, Selleslags J, Van Vreckem A, Van Glabbeke M (1997) Corticosteroids significantly delay the onset of docetaxel-induced fluid retention: final results of a randomized study of the European Organization for Research and Treatment of Cancer Investigational Drug Branch for Breast Cancer. J Clin Oncol Off J Am Soc Clin Oncol 15(9):3149–3155Google Scholar
- 7.Poi MJ, Berger M, Lustberg M, Layman R, Shapiro CL, Ramaswamy B, Mrozek E, Olson E, Wesolowski R (2013) Docetaxel-induced skin toxicities in breast cancer patients subsequent to paclitaxel shortage: a case series and literature review. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 21(10):2679–2686. doi: 10.1007/s00520-013-1842-3 Google Scholar
- 8.Sanofi-Aventis C (2013) “Taxotere” (docetaxel for injection). http://products.sanofi.ca/en/taxotere.pdf. Accessed 4 Nov 2013
- 10.Kawaguchi K, Ishiguro H, Morita S, Nakamura S, Ohno S, Masuda N, Iwata H, Aogi K, Kuroi K, Toi M (2011) Correlation between docetaxel-induced skin toxicity and the use of steroids and H(2) blockers: a multi-institution survey. Breast Cancer Res Treat 130(2):627–634. doi: 10.1007/s10549-011-1641-9 CrossRefPubMedGoogle Scholar
- 11.Schrijvers D, Wanders J, Dirix L, Prove A, Vonck I, van Oosterom A, Kaye S (1993) Coping with toxicities of docetaxel (Taxotere). Ann Oncol Off J Eur Soc Med Oncol / ESMO 4(7):610–611Google Scholar
- 12.Martin M, Pienkowski T, Mackey J, Pawlicki M, Guastalla JP, Weaver C, Tomiak E, Al-Tweigeri T, Chap L, Juhos E, Guevin R, Howell A, Fornander T, Hainsworth J, Coleman R, Vinholes J, Modiano M, Pinter T, Tang SC, Colwell B, Prady C, Provencher L, Walde D, Rodriguez-Lescure A, Hugh J, Loret C, Rupin M, Blitz S, Jacobs P, Murawsky M, Riva A, Vogel C (2005) Adjuvant docetaxel for node-positive breast cancer. N Engl J Med 352(22):2302–2313. doi: 10.1056/NEJMoa043681 CrossRefPubMedGoogle Scholar
- 13.Jones SE, Savin MA, Holmes FA, O’Shaughnessy JA, Blum JL, Vukelja S, McIntyre KJ, Pippen JE, Bordelon JH, Kirby R, Sandbach J, Hyman WJ, Khandelwal P, Negron AG, Richards DA, Anthony SP, Mennel RG, Boehm KA, Meyer WG, Asmar L (2006) Phase III trial comparing doxorubicin plus cyclophosphamide with docetaxel plus cyclophosphamide as adjuvant therapy for operable breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 24(34):5381–5387. doi: 10.1200/jco.2006.06.5391 CrossRefGoogle Scholar
- 14.Martin M, Segui MA, Anton A, Ruiz A, Ramos M, Adrover E, Aranda I, Rodriguez-Lescure A, Grosse R, Calvo L, Barnadas A, Isla D, Martinez del Prado P, Ruiz Borrego M, Zaluski J, Arcusa A, Munoz M, Lopez Vega JM, Mel JR, Munarriz B, Llorca C, Jara C, Alba E, Florian J, Li J, Lopez Garcia-Asenjo JA, Saez A, Rios MJ, Almenar S, Peiro G, Lluch A (2010) Adjuvant docetaxel for high-risk, node-negative breast cancer. N Engl J Med 363(23):2200–2210. doi: 10.1056/NEJMoa0910320 CrossRefPubMedGoogle Scholar
- 15.Roche H, Fumoleau P, Spielmann M, Canon JL, Delozier T, Serin D, Symann M, Kerbrat P, Soulie P, Eichler F, Viens P, Monnier A, Vindevoghel A, Campone M, Goudier MJ, Bonneterre J, Ferrero JM, Martin AL, Geneve J, Asselain B (2006) Sequential adjuvant epirubicin-based and docetaxel chemotherapy for node-positive breast cancer patients: the FNCLCC PACS 01 Trial. J Clin Oncol Off J Am Soc Clin Oncol 24(36):5664–5671. doi: 10.1200/jco.2006.07.3916 CrossRefGoogle Scholar
- 16.Francis P, Crown J, Di Leo A, Buyse M, Balil A, Andersson M, Nordenskjold B, Lang I, Jakesz R, Vorobiof D, Gutierrez J, van Hazel G, Dolci S, Jamin S, Bendahmane B, Gelber RD, Goldhirsch A, Castiglione-Gertsch M, Piccart-Gebhart M (2008) Adjuvant chemotherapy with sequential or concurrent anthracycline and docetaxel: Breast International Group 02-98 randomized trial. J Natl Cancer Inst 100(2):121–133. doi: 10.1093/jnci/djm287 CrossRefPubMedGoogle Scholar
- 17.Goldstein LJ, O’Neill A, Sparano JA, Perez EA, Shulman LN, Martino S, Davidson NE (2008) Concurrent doxorubicin plus docetaxel is not more effective than concurrent doxorubicin plus cyclophosphamide in operable breast cancer with 0 to 3 positive axillary nodes: North American Breast Cancer Intergroup Trial E 2197. J Clin Oncol 26(25):4092–4099. doi: 10.1200/jco.2008.16.7841 PubMedCentralCrossRefPubMedGoogle Scholar
- 20.Burstein HJ, Manola J, Younger J, Parker LM, Bunnell CA, Scheib R, Matulonis UA, Garber JE, Clarke KD, Shulman LN, Winer EP (2000) Docetaxel administered on a weekly basis for metastatic breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 18(6):1212–1219Google Scholar
- 22.Stemmler J, Mair W, Stauch M, Papke J, Deutsch G, Abenhardt W, Dorn B, Kentenich C, Malekmohammadi M, Jackisch C, Leinung S, Brudler O, Vehling-Kaiser U, Stamp J, Heinemann V (2005) High efficacy and low toxicity of weekly docetaxel given as first-line treatment for metastatic breast cancer. Oncology 68(1):71–78. doi: 10.1159/000084823 CrossRefPubMedGoogle Scholar