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
Alice Goodman

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
2020 Year in Review - Breast Cancer
2020 Year in Review - Breast Cancer published on November 28, 2020 in Breast Cancer
JHOP Year in Review Article Sample
2020 Year in Review - Breast Cancer published on November 16, 2020 in Breast Cancer
JHOP Year in Review Article Sample2
2020 Year in Review - Breast Cancer published on November 16, 2020 in Breast Cancer
JHOP Year in Review Article Sample3
2020 Year in Review - Breast Cancer published on November 16, 2020 in Breast Cancer
Surgery and Radiation Do Not Extend Survival in Newly Diagnosed Stage IV Breast Cancer
Patricia Stewart
TOP - November 2020 Vol 13, No 6 published on November 9, 2020 in Breast Cancer
Pembrolizumab Added to First-Line Chemotherapy Improves Progression-Free Survival in Metastatic TNBC
William King
TOP - September 2020 Vol 13, No 5 published on September 14, 2020 in Breast Cancer
Capecitabine Improves Outcomes in TNBC When Added to Other Systemic Therapy
Phoebe Starr
TOP - July 2020, Vol 13, No 4 published on July 15, 2020 in Breast Cancer
Adding CDK4/6 Inhibitor to Endocrine Therapy Improves Survival in Advanced Breast Cancer: New Standard of Care
Phoebe Starr
Web Exclusives published on October 28, 2019 in ESMO, Breast Cancer
Vincristine, Racial Disparities in Multiple Myeloma, and HER2 Metastatic Breast Cancer Are in the News
Web Exclusives published on October 22, 2019 in Breast Cancer, FDA Updates, In the News, Multiple Myeloma, Pediatric Cancer
Talzenna (Talazoparib) New PARP Inhibitor Approved for the Treatment of HER2-Negative Advanced Breast Cancer with Germline BRCA Mutation
Lisa A. Raedler, PhD, RPh, Medical Writer
2019 Fourth Annual Oncology Guide to New FDA Approvals published on June 5, 2019 in Breast Cancer, Drug Updates, FDA Updates
Last modified: April 27, 2020