Stay Up to Date
Breaking News,
Updates, & More
Click Here to
Subscribe

No Association Between Taxane-Induced Neuropathy and Clinical Outcomes in Early Breast Cancer

TOP - October 2012 VOL 5, NO 7 published on November 13, 2012 in Breast Cancer

According to an analysis of the Eastern Cooperative Oncology Group trial ECOG-E1199 by Schneider and colleagues, the development of grade 2 to 4 peripheral neuropathy in patients with operable breast cancer who received taxanes does not appear to affect clinical outcome.1

“We found that, although neuropathy was a common complication that was associated with necessary dose reductions [of taxanes], it was not associated with a higher risk of recurrence or inferior survival,” wrote Bryan P. Schneider, MD, and colleagues. Schneider is affiliated with ECOG at the Indiana University School of Medicine, Indianapolis.

The investigators of this study previously identified several single nucleotide polymorphisms that were significantly associated with an increased risk for developing grade 2 to 4 peripheral neuropathy in patients with breast cancer treated with taxane-containing chemotherapy. The present study suggests that this biomarker will not be useful for identifying patients who will derive preferential benefit from taxane therapy.

“This finding provides reassurance that biomarkers predictive for neuropathy will likely not enrich for patients who are more likely to benefit from taxane therapy and may also be useful for the identification of patients who are most likely to benefit from adjunctive therapies to mitigate neuropathy,” wrote the authors.

The study population included 4554 women with operable breast cancer—either axillary node-positive or high-risk node-negative breast cancer. They were treated with up to 4 cycles of doxorubicin/cyclophosphamide every 3 weeks and then randomized to 1 of 4 treatment arms: 4 cycles of paclitaxel 175 mg/m2 every 3 weeks (arm P3), 12 cycles of paclitaxel 80 mg/m2 every week (arm P1), 4 cycles of docetaxel 100 mg/m2 every 3 weeks (arm D3), or 12 cycles of docetaxel 35 mg/m2 every week (arm D1). Grade 2 to 4 peripheral neuropathy was evaluated using the National Can­cer Institute Common Toxicity Criteria (version 2.0) grading scale. End points were overall survival, disease-free survival, and recurrence-free survival.

Grade 2 to 4 neuropathy developed in 18%, 22%, 15%, and 13% of patients in the P3, P1, D3, and D1 treatment arms, respectively. In a model adjusted for age, race, obesity, menopausal status, tumor size, nodal status, treatment arm, neuropathy, and hypergly­cemia, no significant relationship was observed between neuropathy and the 3 end points.

The risk of neuropathy was decreased in premenopausal patients compared with postmenopausal patients, and the risk of neuropathy was higher in blacks than in other races and in obese patients versus nonobese patients. The association between hyperglycemia and neuropathy was significant and remained significant after adjusting for age, race, obesity, and menopausal status. Hy­pe­r­glycemia was also associated with inferior outcomes, but only in the P3 arm.

“These findings must…be interpreted with caution because treatment-associated hyperglycemia may be multifactorial and not reflect patients with a formal diagnosis of diabetes,” the authors wrote.

Reference

  1. Schneider BP, Zhao F, Wang M, et al. Neuropathy is not associated with clinical outcomes in patients receiving adjuvant taxane-containing therapy for operable breast cancer. J Clin Oncol. 2012;30:3051-3057.

 

Related Items
Olaparib Extends Disease-Free Survival in Patients with Early-Stage Breast Cancer and BRCA Mutation
William King
TOP - November 2021 Vol 14, No 7 published on November 10, 2021 in Breast Cancer
Tucatinib plus Trastuzumab and Capecitabine Triplet Maintains Survival Benefit in HER2-Positive Metastatic Breast Cancer: Updated Results from HER2CLIMB Trial
Charlie Dawson
TOP - September 2021 Vol 14, No 5 published on September 7, 2021 in Breast Cancer
Cryoablation Appears Safe and Effective in Low-Risk, Early-Stage Breast Cancer
William Ackerman
TOP - July 2021 Vol 14, No 4 published on July 20, 2021 in Breast Cancer
Pembrolizumab plus Chemotherapy Improves Progression-Free Survival in Metastatic TNBC
Patricia Stewart
TOP - May 2021 Vol 14, No 3 published on May 14, 2021 in Breast Cancer
Abemaciclib plus Endocrine Therapy Offers Invasive Disease–Free Survival Benefit in Patients with High-Risk, HR-Positive, Early-Stage Breast Cancer
Patricia Stewart
TOP - May 2021 Vol 14, No 3 published on May 14, 2021 in Breast Cancer
Breast Cancer Year in Review Introduction
2020 Year in Review - Breast Cancer published on January 24, 2021 in Breast Cancer
Retrospective Analysis Provides Insight into Treatment-Emergent Neutropenia Among Patients with Metastatic Breast Cancer Treated with Ribociclib or Palbociclib
2020 Year in Review - Breast Cancer published on January 24, 2021 in Breast Cancer
Concurrent Use of Medications with Potential Drug–Drug Interactions: Real-World Analysis of Patients Treated with CDK4/6 Inhibitors
2020 Year in Review - Breast Cancer published on January 24, 2021 in Breast Cancer
Abemaciclib plus Fulvestrant Provides Statistically Significant Benefit as First- and Second-Line Therapy for Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer
2020 Year in Review - Breast Cancer published on January 24, 2021 in Breast Cancer
Preliminary Results from a Phase 2 Trial of Fulvestrant/Palbociclib as First-Line Therapy in Postmenopausal Women with Hormone Receptor–Positive, HER2-Negative Endocrine-Sensitive Advanced Breast Cancer
2020 Year in Review - Breast Cancer published on January 24, 2021 in Breast Cancer
Last modified: July 22, 2021