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

  • Rashi Asthana
  • Liying Zhang
  • Bo Angela Wan
  • Daniela Gallo-Hershberg
  • Angie Giotis
  • Mark Pasetka
  • Jenna van Draanen
  • Shannon Goodall
  • Patrick L. Diaz
  • Leah Drost
  • Edward Chow
  • Carlo De AngelisEmail author
Original Article



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.


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).


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).


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.


Breast cancer Taxane Pain descriptors Taxane acute pain syndrome (TAPS) Chemotherapy-induced pain (ChIP) 


Author 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.


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.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

520_2019_4845_MOESM1_ESM.docx (64 kb)
ESM 1 (DOCX 63 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Rashi Asthana
    • 1
    • 2
  • Liying Zhang
    • 1
  • Bo Angela Wan
    • 1
  • Daniela Gallo-Hershberg
    • 3
    • 2
  • Angie Giotis
    • 1
  • Mark Pasetka
    • 1
  • Jenna van Draanen
    • 4
  • Shannon Goodall
    • 1
  • Patrick L. Diaz
    • 1
  • Leah Drost
    • 1
  • Edward Chow
    • 1
  • Carlo De Angelis
    • 1
    • 2
    Email author
  1. 1.Department of PharmacyOdette Cancer Centre, Sunnybrook Health Sciences CentreTorontoCanada
  2. 2.Leslie Dan Faculty of PharmacyUniversity of TorontoTorontoCanada
  3. 3.Cancer Care Ontario 620 University AveTorontoCanada
  4. 4.Department of SociologyUniversity of British Columbia Vancouver CampusVancouverCanada

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