Age and the Risk of Paclitaxel-Induced Neuropathy in Women with Early-Stage Breast Cancer (Alliance A151411): Results from 1,881 Patients from Cancer and Leukemia Group B (CALGB) 40101

The oncologist

article

Myra Barginear¹  Stuart Lichtman²  Hyman B. Muss³  Lawrence N. Shulman⁴  M. Sitiki Copur⁵  David Biggs⁶  Bhuvaneswari Ramaswamy⁷  Jacqueline M. Lafky⁸  Aminah Jatoi⁸  Amylou C. Dueck⁹  Jacob B. Allred^1,10  Craig Bunnell^1,11  Harvey J. Cohen^1,12  Rachel A. Freedman^1,14  Arti Hurria^1,15  Gretchen Kimmick^1,13  Jennifer G. Le-Rademacher^1,10 

[1] Northwell Health Cancer Institute;Memorial Sloan Kettering Cancer Center;University of North Carolina at Chapel Hill;Abramson Cancer Center, University of Pennsylvania;Saint Francis Cancer Treatment Center, University of Nebraska Medical Center;Christiana Care Health System-Christiana Hospital;Ohio State University Comprehensive Cancer Center;Department of Oncology, Mayo Clinic;Department of Health Sciences Research, Mayo Clinic;Alliance Statistics and Data Center, Mayo Clinic;Pancreatic Cancer Action Networ;Center for the Study of Aging and Human Development and, Duke University Medical Center;Duke Cancer Institute, Duke University Medical Center;Dana-Farber/Partners CancerCare;City of Hope

关键词: Paclitaxel;    Neuropathy;    Older;    Geriatric;    Breast cancer;   

DOI  :  10.1634/theoncologist.2018-0298

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Purpose A few previous studies report a direct relationship between older age and chemotherapy-induced neuropathy. This study further evaluated this adverse event's age-based risk. Methods CALGB 40101 investigated adjuvant paclitaxel (80 mg/m 2 once per week or 175 mg/m 2 every 2 weeks) in patients with breast cancer and served as a platform for the current study that investigated age-based differences in neuropathy. Grade 2 or worse neuropathy, as per Common Terminology Criteria for Adverse Events version 4, was the primary endpoint; patients were assessed at baseline, every 6 months for 2 years, and then annually for 15 years. Results Among these 1,881 patients, 230 were 65 years of age or older, 556 were 55–64 years, and 1,095 were younger than 55; 1,226 neuropathy events (commonly grade 1 or 2) were reported in 65% of the cohort. The number of grade 2 or worse events was 63 (27%), 155 (28%), and 266 (24%) within respective age groups ( p = .14). In univariate analysis, only motor neuropathy had a higher age-based incidence: 19 (8%), 43 (8%), and 60 (5%), respectively ( p = .04); in multivariate analyses, this association was no longer statistically significant. Other endpoints, such as time to onset of neuropathy (time from trial enrollment to neuropathy development) and time to improvement (time from maximal grade sensory neuropathy to a one-category improvement), showed no statistically significant age-based differences. In contrast, obesity was associated with neuropathy, and every 2-week paclitaxel was associated with trends toward neuropathy. Conclusion Although paclitaxel-induced neuropathy is common, older age is not an independent risk factor. Clinical trial identification number . NCT00041119 (CALGB 40101). Implications for Practice Age alone is not an independent risk factor for paclitaxel-induced neuropathy.

【 授权许可】

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