Abstract
Objective: Prospectively characterize and compare the clinical features, severity and incidence of chemotherapy induced peripheral neuropathy (CIPN) among patients exposed to docetaxel versus paclitaxel.
Background: CIPN is the second most common dose-limiting side effect of microtubule inhibitor based chemotherapies including the taxanes. Recognition of CIPN is necessary to make treatment decisions. The relative risk and severity of CIPN associated with docetaxel and paclitaxel has not been well defined.
Design/Methods: Patients with breast cancer receiving either paclitaxel or docetaxel chemotherapy were prospectively evaluated prior to initiation of chemotherapy at 3–6 week intervals during and after treatment. The following assessments were then performed: the Neuropathy Total Symptom Score (NTSS-6), the Utah Early Neuropathy Score (UENS), and a CIPN specific quality of life scale, the European Organization for Research and Treatment of Cancer-20 (EORTC-20). CIPN was defined based on the combination of symptoms and signs. The incidence and severity of CIPN was determined and compared between those receiving docetaxel and paclitaxel.
Results: 21 participants each received docetaxel or paclitaxel. CIPN developed in 3/21 (14%) in the docetaxel group and 15/21 (71%) in the paclitaxel group. Age, cancer, respective cumulative dose and side effect profile were similar between both treatment groups. While the paclitaxel treated patients had significantly greater CIPN incidence there was no difference in severity in paclitaxel vs. docetaxel comparisons: NTSS6 (4.3+/− 2.5 vs. 2.4+/−1.3, p>0.05); UENS (6.6+/−4.7 vs. 3.0+/−1.7 p>0.05); EORTC (30.0+/−8.4 vs. 24.0+/−1 p>0.05).
Conclusions: The incidence but not severity of CIPN is significantly higher in women treated with paclitaxel when compared to docetaxel. Fully understanding the differences in the development of CIPN between the taxanes is crucial for making treatment decisions and managing patients with breast cancer.
Disclosure: Dr. Karafiath has nothing to disclose. Dr. Kolb has nothing to disclose. Dr. Singleton has nothing to disclose. Dr. Smith has received personal compensation for activities with CSL Behring, Grifols, and Allergan as a consultant. Dr. Smith has received personal compensation in an editorial capacity for NeuroLearn. Dr. Smith has received research support from the NIH, the ADA, and Impeto.
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