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Supportive Care in Cancer

, Volume 24, Issue 4, pp 1583–1594 | Cite as

Treatment of taxane acute pain syndrome (TAPS) in cancer patients receiving taxane-based chemotherapy—a systematic review

  • Ricardo Fernandes
  • Sasha Mazzarello
  • Habeeb Majeed
  • Stephanie Smith
  • Risa Shorr
  • Brian Hutton
  • Mohammed FK Ibrahim
  • Carmel Jacobs
  • Michael Ong
  • Mark Clemons
Original Article

Abstract

Background

Taxane acute pain syndrome (TAPS) is characterized by myalgias and arthralgias starting 1–3 days and lasting 5–7 days after taxane-based chemotherapy. Despite negatively impacting patient’s quality of life, little is known about the optimal TAPS management. A systematic review of treatment strategies for TAPS across all tumor sites was performed.

Methods

Embase, Ovid MEDLINE(R), and the Cochrane Central Register of Controlled Trials were searched from 1946 to October 2014 for trials reporting the effectiveness of different treatments of TAPS in cancer patients receiving taxane-based chemotherapy. Two individuals independently screened citations and full-text articles for eligibility. Outcome measures included type of treatment and response of myalgias, arthralgias, pain, and quality of life (QoL).

Results

Of 1614 unique citations initially identified, five studies met the pre-specified eligibility criteria. Two were randomized placebo-controlled trials (225 patients), two were randomized open-label trials 76 patients), and one was a retrospective study (10 patients). The agents investigated included gabapentin, amifostine, glutathione, and glutamine. Study sizes ranged from 10 to 185 patients. Given the heterogeneity of study designs, a narrative synthesis of results was performed. Neither glutathione (QoL, p = 0.30, no 95 % CI reported) nor glutamine (mean improvement in average pain was 0.8 in both treatment arms, p = 0.84, no 95 % CI reported) were superior to placebo. Response to amifostine (pain response) and gabapentin (reduction in taxane-induced arthralgias and myalgias) was 36 % (95 % CI, 16–61 %) and 90 % (no 95 % CI data reported), respectively.

Conclusions

Despite its prevalence in patients receiving taxane-based chemotherapies, TAPS remains poorly researched and few studies evaluate its optimal management. If the management of patients is to be improved, more prospective trials are needed.

Keywords

Taxane acute pain syndrome Docetaxel Paclitaxel Gabapentin Amifostine Glutathione Glutamine 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ricardo Fernandes
    • 1
  • Sasha Mazzarello
    • 2
  • Habeeb Majeed
    • 3
  • Stephanie Smith
    • 2
  • Risa Shorr
    • 4
  • Brian Hutton
    • 5
  • Mohammed FK Ibrahim
    • 1
  • Carmel Jacobs
    • 1
  • Michael Ong
    • 1
  • Mark Clemons
    • 1
    • 2
    • 6
  1. 1.Division of Medical Oncology, Department of MedicineThe Ottawa Hospital and University of OttawaOttawaCanada
  2. 2.Ottawa Hospital Research Institute and University of OttawaOttawaCanada
  3. 3.Division of Internal Medicine, Department of MedicineThe Ottawa HospitalOttawaCanada
  4. 4.The Ottawa HospitalOttawaCanada
  5. 5.Department of Epidemiology and Community MedicineUniversity of OttawaOttawaCanada
  6. 6.Division of Medical OncologyThe Ottawa Hospital Cancer CentreOttawaCanada

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