Neuropathy is not associated with clinical outcomes in patients receiving adjuvant taxane-containing therapy for operable breast cancer.

Abstract

PURPOSE:

Neuropathy is a common and potentially disabling complication of adjuvant taxane therapy. Recent studies have identified candidate single nucleotide polymorphisms associated with taxane-induced neuropathy. Therefore, we sought to determine whether neuropathy was associated with breast cancer recurrence in a clinical trial population who received adjuvant taxane therapy.

PATIENTS AND METHODS:

Trial E1199 included 4,554 eligible women with operable breast cancer who received up to four cycles of doxorubicin and cyclophosphamide every 3 weeks followed by paclitaxel 175 mg/m(2) every 3 weeks for four cycles (P3), paclitaxel 80 mg/m(2) weekly for 12 cycles (P1), docetaxel 100 mg/m(2) every 3 weeks for four cycles (D3), or docetaxel 35 mg/m(2) weekly for 12 cycles (D1). A Cox proportional hazards model was used to determine the relationship between neuropathy and disease-free survival (DFS), overall survival (OS), and recurrence-free survival (RFS) by treating neuropathy status as a time dependent covariate and using a landmark analysis.

RESULTS:

Of 4,554 patients who received at least one taxane dose, grade 2 to 4 neuropathy developed in 18%, 22%, 15%, and 13% of patients in the P3, P1, D3, and D1 arms, respectively. In a model that included age, race, obesity, menopausal status, tumor size, nodal status, treatment arm, neuropathy, and hyperglycemia, no significant relationship was found between neuropathy and DFS, OS, or RFS.

CONCLUSION:

There was no association between taxane-induced neuropathy and outcome.

• Authors: Bryan P Schneider, Fengmin Zhao, Molin Wang, Vered Stearns, Silvana Martino, Vicky Jones, Edith A Perez, Tom Saphner, Antonio C Wolff, George W Sledge Jr, William C Wood, Nancy E Davidson, Joseph A Sparano
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 30 Issue 25 Pg. 3051-7 (Sep 01 2012) ISSN: 1527-7755 [Electronic] United States
• PMID: 22851566 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Webcast)

Chemical References

• Doxorubicin
• Cyclophosphamide
• Paclitaxel

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Breast Neoplasms (drug therapy, mortality, surgery)
• Chemotherapy, Adjuvant
• Cyclophosphamide (administration & dosage)
• Disease-Free Survival
• Doxorubicin (administration & dosage)
• Female
• Humans
• Kaplan-Meier Estimate
• Logistic Models
• Mastectomy (adverse effects, mortality)
• Middle Aged
• Multivariate Analysis
• Nervous System Diseases (chemically induced, mortality)
• Paclitaxel (administration & dosage)
• Proportional Hazards Models
• Risk Assessment
• Risk Factors
• Time Factors
• Treatment Outcome
• United States