| Title | Association of Taxane Type With Patient-Reported Chemotherapy-Induced Peripheral Neuropathy Among Patients With Breast Cancer |
| Authors | Mo, Hongnan Yan, Xiaoyan Zhao, Fang Teng, Yuee Sun, Xiaoying Lv, Zheng Cao, Mengru Zhao, Jiuda Song, Guohong Pan, Bo Li, Huihui Zhai, Jingtong Xu, Binghe Ma, Fei |
| Affiliation | Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Clin Res Ctr Canc, Dept Med Oncol,Natl Canc Ctr, 17 Panjiayuan Nanli, Beijing 100021, Peoples R China Peking Univ, Clin Res Inst, Dept Biostat, Beijing, Peoples R China China Med Univ, Hosp 1, Dept Med Oncol, Shenyang, Peoples R China Canc Hosp HuanXing ChaoYang Dist, Dept Med Oncol, Beijing, Peoples R China Jilin Univ, Affiliated Hosp 1, Canc Ctr, Changchun, Peoples R China Harbin Med Univ, Canc Hosp, Dept Med Oncol, Harbin, Peoples R China Qinghai Univ, Affiliated Hosp, Breast Dis Diag & Treatment Ctr, Xining, Peoples R China Qinghai Univ, Affiliated Canc Hosp, Xining, Peoples R China Peking Univ, Canc Hosp & Inst, Dept Breast Oncol, Beijing, Peoples R China Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Breast Surg, Beijing, Peoples R China Shandong First Med Univ & Shandong Acad Med Sci, Shandong Canc Hosp & Inst, Dept Breast Med Oncol, Jinan, Peoples R China |
| Keywords | PROPENSITY SCORE OUTCOME MEASURES NAB-PACLITAXEL HIGH-RISK WOMEN TRIAL QUESTIONNAIRE PREVENTION |
| Issue Date | 2-Nov-2022 |
| Publisher | JAMA NETWORK OPEN |
| Abstract | IMPORTANCE Understanding the detailed symptom spectrum of chemotherapy-induced peripheral neuropathy (CIPN) could facilitate shared decision-making and promote early intervention. OBJECTIVE To compare the symptom spectrum of patient-reported CIPN associated with nab-paclitaxel, paclitaxel, and docetaxel treatments among patients with breast cancer. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted at 9 medical centers across China from 2019 to 2021. Participants included hospitalized women diagnosed with invasive breast cancer, assessed with overlap propensity score weighting. Data were analyzed from from December 2021 to May 2022. EXPOSURES Treatment with nab-paclitaxel-, paclitaxel-, or docetaxel-based regimens. MAIN OUTCOMES AND MEASURES Patient-reported CIPN on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire: CIPN 20-item instruments, consisting of sensory, motor, and autonomic scales. Multiple regression models were adjusted for baseline patient, tumor, and treatment characteristics. RESULTS Of 1234 participants, the mean (SD) age was 50.9 (10.4) years, and 295 patients (23.9%) received nab-paclitaxel, 514 patients (41.7%) received paclitaxel, and 425 patients (34.4%) received docetaxel. The nab-paclitaxel group mostly reported numbness in hands or feet related to sensory symptoms (83 patients [81.4%]), while the paclitaxel and docetaxel groups reported mainly motor (eg, weakness in legs: 60 patients [47.2%] in the paclitaxel group; 52 patients [44.4%] in the docetaxel group) and autonomic (eg, blurred vision: 58 patients [45.7%] in the paclitaxel group; 51 patients [43.6%] in the docetaxel group) symptoms. Patients reported motor symptoms earlier than sensory abnormalities, with a median of 0.4 (95% CI, 0.4-2.3) weeks in the nab-paclitaxel group, 2.7 (95% CI, 1.7-3.4) weeks in the paclitaxel group, and 5.6 (95% CI, 3.1-6.1) weeks in the docetaxel group. After overlap propensity score weighting and compared with the nab-paclitaxel group, the risks of patient-reported CIPN were lower in the paclitaxel (hazard ratio [HR], 0.59 [95% CI, 0.41-0.87]; P = .008) and the docetaxel (HR, 0.65 [95% CI, 0.45-0.94]; P = .02) groups. Similarly, patients who received paclitaxel (HR, 0.44 [95% CI, 0.30-0.64]; P < .001) or docetaxel (HR, 0.52 [95% CI, 0.36-0.75]; P < .001) reported less sensory discomfort compared with those who received nab-paclitaxel. However, the risk of patients in the paclitaxel or docetaxel groups reporting motor (paclitaxel: HR, 0.76 [95% CI, 0.52-1.11]; P = .15; docetaxel: HR, 0.69 [95% CI, 0.47-1.01]; P = .05) and/or autonomic (paclitaxel: HR, 1.00 [95% CI, 0.68-1.49]; P = .98; docetaxel: HR, 0.88 [95% CI, 0.59-1.30]; P = .52) symptoms was not lower than that in the nab-paclitaxel group. CONCLUSIONS AND RELEVANCE In this cohort study of women with invasive breast cancer, nab-paclitaxel was associated with more severe CIPN than either paclitaxel or docetaxel. In addition to sensory symptoms, the risk of motor and autonomic abnormalities was not low among these 3 taxanes, and patients-reported motor symptoms even earlier than sensory symptoms. These findings may facilitate early detection and intervention for CIPN in taxane treatments for breast cancer. |
| URI | http://hdl.handle.net/20.500.11897/658124 |
| ISSN | 2574-3805 |
| DOI | 10.1001/jamanetworkopen.2022.39788 |
| Indexed | SCI(E) |
| Appears in Collections: | 北京肿瘤医院 |
