(050) Correlates of neuropathy in patients with breast cancer receiving taxane based neoadjuvant or adjuvant chemotherapy

Poster Abstract:

Background: Taxane-induced neuropathy is associated with axonal sensory neuropathy which depends on cumulative dosage, pre-existing comorbidities, and prior or concurrent treatment with other drugs [1]. These symptoms are reported in up to 97% of patients with breast cancer based on a retrospective chart data and 60% of these patients experienced symptom progression to chronic neuropathy [3, 4, 5]. A history of diabetes or prediabetes can further exacerbate the onset of neuropathy; however, there is no consensus regarding its management in clinical practice [2]. Along with this, there are various other risk factors that may contribute to early onset of neuropathy with taxane based treatment and the identification of these risk factors will assist in managing and further prevent worsening of this highly prevalent toxicity. We aim to conduct this retrospective chart review to identify demographic and clinical risk factors (e.g. age, sex, BMI, blood glucose values, cumulative steroid dosage, abnormal creatinine clearance, smoking history) associated with the development of peripheral neuropathy in breast cancer patients receiving neoadjuvant or adjuvant taxane based chemotherapy with paclitaxel, albumin-bound paclitaxel or docetaxel.
Primary objective: To assess glucose control prior to and during taxane treatment and its relationship to onset of neuropathy in patients diagnosed with breast cancer receiving taxane based neoadjuvant or adjuvant chemotherapy (paclitaxel, albumin-bound paclitaxel, docetaxel).
Secondary objective(s): To assess whether certain clinical factors such as age, sex, reduced kidney function, obesity, cumulative corticosteroid dose, serum albumin, history of hepatic steotosis, vitamin D levels, neutrophil to lymphocyte ratio (NLR), diabetes, or prediabetes contribute to development of neuropathy in patients diagnosed with breast cancer receiving taxane based neoadjuvant or adjuvant chemotherapy (paclitaxel, albumin-bound paclitaxel, docetaxel)

Methods: Pearson’s χ2 tests for categorical variables and Student’s t tests for continuous variables to compare characteristics of patients who received taxane treatment by incidence of CIPN. Univariate and multivariate regression analyses will be used to evaluate odds ratios and 95% confidence intervals of chemotherapy-induced neuropathy (CIPN) associated with blood glucose and other demographic variables of interest [age, sex, BMI, kidney function, past medical history of diabetes or prediabetes, serum albumin, hx of hepatic steatosis, vitamin D levels, neutrophil to lymphocyte ratio, cumulative corticosteroid dose]. All statistical tests were based on two-tailed probability and a significance level set at alpha less than 0.05. Statistical analyses will be performed with assistance from University of Arizona faculty using SAS software.
Results/Discussion/

Conclusions: pending

References (must also be included in final poster): 1. Klein, I., Lehmann, H. Toxics. 2021; 9 (10): 229. doi:10.3390/toxics9100229 5. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf
2. Gu, J., Lu, H., Chen, C., et al. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer. 2021; 29 (12): 7461-7469. doi:10.1007/s00520-021-06321-7 12. https://www.nccn.org/professionals/physician_gls/pdf/pain.pdf
3. Ghoreishi, Z., Keshavarz, S., Jafarabadi, A., et al. BMC Cancer. 2018; 18: 958. https://doi.org/10.1186/s12885-018-4869-5
4. Klein, I., Lehmann, H. Toxics. 2021; 9 (10): 229. doi:10.3390/toxics9100229
5. Hershman, D., Till, C., Wright, J., et al. Journal of Clinical Oncology. 2016; 34: 3014–3022.