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Dexamethasone dose-dependently prevents taxane-associated acute pain syndrome in breast cancer treatment

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Abstract

Purpose

Taxane-associated acute pain syndrome (T-APS) is one of the most bothersome adverse effects caused by taxanes. We have previously reported the attenuating effect of dexamethasone (DEX) on T-APS and its risk factors under DEX prophylaxis. However, the appropriate DEX dosage administration remains unclear. Therefore, this study aimed to investigate whether DEX dose-dependently prevents T-APS in breast cancer patients.

Methods

We retrospectively evaluated patients with breast cancer who received docetaxel (75 mg/m2)-containing chemotherapy without pegfilgrastim and regular non-steroidal anti-inflammatory drugs. The patients were divided into 4 mg/day and 8 mg/day DEX groups, with each DEX dosage on days 2–4 (n = 68 for each group). Primary endpoint was the comparison of all-grade T-APS incidence between the groups. Propensity score-matching was performed to adjust the baseline factors between the groups, and outcomes in the matched-population were also assessed.

Results

The incidence of all-grade T-APS was 72.1% in 4 mg/day group and 48.5% in 8 mg/day group, which was significantly lowered by higher DEX dosage (P = 0.008). The severity of T-APS was also significantly reduced in 8 mg/day group (P = 0.02). These results were confirmed in the propensity score matching. Multivariate logistic analysis showed that higher DEX dosage was an independent T-APS preventive factor, whereas age < 55 years was a risk factor. Moreover, DEX-dosage-associated adverse effects similarly appeared in both groups.

Conclusion

Our study suggested that DEX dose-dependently prevents T-APS in breast cancer treatment. As understanding of the nature of T-APS and its appropriate management can significantly contribute to less onerous chemotherapy provision, further studies are required.

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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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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 & Mitsuru Sugawara

  2. Department of Breast Surgery, Hokkaido University Hospital, Kita 14-Jo, Nishi 5-Chome, Kita-Ku, Sapporo, 060-8648, Japan

    Takashi Takeshita & Tomohiro Oshino

  3. Laboratory of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hokkaido University, Kita 12-Jo, Nishi 6-Chome, Kita-Ku, Sapporo, 060-0812, Japan

    Mitsuru Sugawara

Authors
  1. Yoshitaka Saito
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  2. Yoh Takekuma
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  4. Tomohiro Oshino
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  5. Mitsuru Sugawara
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Contributions

Participated in research design: YS and YT.

Conducted experiments: YS.

Performed data analysis: YS.

Wrote or contributed to the writing of the manuscript: YS, YT, TT, TO, and MS.

Corresponding author

Correspondence to Mitsuru Sugawara.

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All the procedures performed in studies involving human participants were carried out in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Saito, Y., Takekuma, Y., Takeshita, T. et al. Dexamethasone dose-dependently prevents taxane-associated acute pain syndrome in breast cancer treatment. Support Care Cancer 31, 372 (2023). https://doi.org/10.1007/s00520-023-07852-x

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