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Paclitaxel-induced peripheral neuropathy in patients receiving adjuvant chemotherapy for breast cancer

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Abstract

Background

The long-term outcomes and risk factors of paclitaxel-induced peripheral neuropathy (PIPN) have not yet been fully elucidated.

Methods

We identified 219 breast cancer patients who received paclitaxel as adjuvant chemotherapy between 2002 and 2009. We retrospectively analyzed the incidence, time to onset, duration, and risk factors for PIPN by chart review.

Results

Of the 219 patients, 212 developed PIPN (97%) during a median follow-up time of 57 months (range 5.3–95.5). Median time to PIPN onset was 21 days (range 11–101) for the entire patient population: 35 days (range 14–77) for weekly administration and 21 days (range 11–101) for tri-weekly administration. PIPN caused termination of paclitaxel treatment in 7 patients (4%). Median duration of PIPN was 727 days (range 14–2621 days). PIPN persisted in 64 and 41% of patients at 1 and 3 years after initiating paclitaxel, respectively. Age ≥60 years and severity of PIPN were significantly associated with PIPN duration.

Conclusions

PIPN persists longer in older patients and in those who experience severe neuropathy. Further studies to identify the risk factors for PIPN are warranted.

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References

  1. Henderson IC, Berry DA, Demetri GD et al (2003) Improved outcomes from adding sequential paclitaxel but not from escalating doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol 21:976–983

    Article  PubMed  CAS  Google Scholar 

  2. Mamounas EP, Bryant J, Lembersky B et al (2005) Paclitaxel after doxorubicin plus cyclophosphamide as adjuvant chemotherapy for node-positive breast cancer: results from NSABP B-28. J Clin Oncol 23:3686–3696

    Article  PubMed  CAS  Google Scholar 

  3. Buzdar AU, Singletary SE, Valero V et al (2002) Evaluation of paclitaxel in adjuvant chemotherapy for patients with operable breast cancer: preliminary data of a prospective randomized trial. Clin Cancer Res 8:1073–1079

    PubMed  CAS  Google Scholar 

  4. De Laurentiis M, Cancello G, D’Agostino D et al (2008) Taxane-based combinations as adjuvant chemotherapy of early breast cancer: a meta-analysis of randomized trials. J Clin Oncol 26:44–53

    Article  PubMed  Google Scholar 

  5. Rowinsky EK, Donehower RC (1995) Paclitaxel (Taxol). N Engl J Med 332:1004–1014

    Article  PubMed  CAS  Google Scholar 

  6. Akerley W, Herndon JE, Egorin MJ et al (2003) Weekly, high-dose paclitaxel in advanced lung carcinoma: a phase II study with pharmacokinetics by the Cancer and Leukemia Group B. Cancer 97:2480–2486

    Article  PubMed  CAS  Google Scholar 

  7. Winer EP, Berry DA, Woolf S et al (2004) Failure of higher-dose paclitaxel to improve outcome in patients with metastatic breast cancer: Cancer and Leukemia Group B trial 9342. J Clin Oncol 22:2061–2068

    Article  PubMed  CAS  Google Scholar 

  8. Nabholtz JM, Gelmon K, Bontenbal M et al (1996) Multicenter, randomized comparative study of two doses of paclitaxel in patients with metastatic breast cancer. J Clin Oncol 14:1858–1867

    PubMed  CAS  Google Scholar 

  9. Gogas H, Shapiro F, Aghajanian C et al (1996) The impact of diabetes mellitus on the toxicity of therapy for advanced ovarian cancer. Gynecol Oncol 61:22–26

    Article  PubMed  CAS  Google Scholar 

  10. Rowinsky EK, Eisenhauer EA, Chaudhry V et al (1993) Clinical toxicities encountered with paclitaxel (Taxol). Semin Oncol 20:1–15

    PubMed  CAS  Google Scholar 

  11. Rowinsky EK, Chaudhry V, Cornblath DR et al (1993) Neurotoxicity of taxol. J Natl Cancer Inst Monogr 15:107–115

    PubMed  Google Scholar 

  12. Lee JJ, Swain SM (2006) Peripheral neuropathy induced by microtubule-stabilizing agents. J Clin Oncol 24:1633–1642

    Article  PubMed  CAS  Google Scholar 

  13. Seidman AD, Berry D, Cirrincione C et al (2008) Randomized phase III trial of weekly compared with every-3-weeks paclitaxel for metastatic breast cancer, with trastuzumab for all HER-2 overexpressors and random assignment to trastuzumab or not in HER-2 nonoverexpressors: final results of Cancer and Leukemia Group B protocol 9840. J Clin Oncol 26:1642–1649

    Article  PubMed  CAS  Google Scholar 

  14. Sparano JA, Wang M, Martino S et al (2008) Weekly paclitaxel in the adjuvant treatment of breast cancer. N Engl J Med 358:1663–1671

    Article  PubMed  CAS  Google Scholar 

  15. Jones SE, Erban J, Overmoyer B et al (2005) Randomized phase III study of docetaxel compared with paclitaxel in metastatic breast cancer. J Clin Oncol 23:5542–5551

    Article  PubMed  CAS  Google Scholar 

  16. Goldhirsch A, Wood WC, Gelber RD et al (2007) Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol 18:1133–1144

    Google Scholar 

  17. Goldhirsch A, Ingle JN, Gelber RD et al, Panel members (2009) Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol 20:1319–1329

    Google Scholar 

  18. Trotti A, Colevas AD, Setser A et al (2003) CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol 13:176–181

    Article  PubMed  Google Scholar 

  19. Chaudhry V, Rowinsky EK, Sartorius SE et al (1994) Peripheral neuropathy from Taxol and cisplatin combination chemotherapy: clinical and electrophysiological studies. Ann Neurol 35:304–311

    Article  PubMed  CAS  Google Scholar 

  20. Wang MS, Davis AA, Culver DG et al (2002) WldS mice are resistant to paclitaxel (Taxol) neuropathy. Ann Neurol 52:442–447

    Article  PubMed  Google Scholar 

  21. Aplenc R, Glatfelter W, Han P et al (2003) CYP3A genotypes and treatment response in paediatric acute lymphoblastic leukaemia. Br J Haematol 122:240–244

    Article  PubMed  CAS  Google Scholar 

  22. Siau C, Bennett GJ (2006) Dysregulation of cellular calcium homeostasis in chemotherapy-evoked painful peripheral neuropathy. Anaesth Analg 102:1485–1490

    Article  CAS  Google Scholar 

  23. Argyriou AA, Koltzenburg M, Polychronopoulos P et al (2008) Peripheral nerve damage associated with administration of taxanes in patients with cancer. Crit Rev Oncol Hematol 66:218–228

    Article  PubMed  Google Scholar 

  24. Gauchan P, Andoh T, Ikeda K et al (2009) Mechanical allodynia induced by paclitaxel, oxaliplatin and vincristine: Different effectiveness of gabapentin and different expression of voltage dependent calcium channel α2δ-1 subunit. Biol Pharm Bull 32:732–734

    Article  PubMed  CAS  Google Scholar 

  25. Cavaletti G, Frigeni B, Lanzani F et al (2010) Chemotherapy-induced peripheral neurotoxicity assessment: a critical revision of the currently available tools. Eur J Cancer 46:479–494

    Article  PubMed  CAS  Google Scholar 

  26. Postma TJ, Heimans JJ, Muller MJ et al (1998) Pitfalls in grading severity of chemotherapy-induced peripheral neuropathy. Ann Oncol 9:739–744

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Ms. Nao Nakamura for helping with manuscript revision. This work was supported by a Scientific Research Grant of the Ministry of Health, Labour and Welfare (H21-O21).

Conflict of interest

The authors have declared no conflicts of interest.

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Correspondence to Chikako Shimizu.

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Tanabe, Y., Hashimoto, K., Shimizu, C. et al. Paclitaxel-induced peripheral neuropathy in patients receiving adjuvant chemotherapy for breast cancer. Int J Clin Oncol 18, 132–138 (2013). https://doi.org/10.1007/s10147-011-0352-x

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  • DOI: https://doi.org/10.1007/s10147-011-0352-x

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