Background: Taxanes used to treat breast cancer can cause chemotherapy-induced peripheral neuropathy (CIPN). In phase III trials, ≥ grade 2 neuropathy affected 16% and 27% of patients receiving 3-weekly docetaxel vs weekly paclitaxel respectively1.
Aim: To assess patient-reported sustained CIPN in breast cancer survivors.
Methods: Review of prospectively collected data from patients’ initial appointment at the Sydney Survivorship Centre clinic (SSC). Patients scored the severity of numbness and tingling affecting their hands and feet from 0 (none) to 10 (worst). Analysis was descriptive with comparisons by independent samples t-test.
Results: Overall, 191 women with breast cancer attended SSC between December 2013 - June 2018. Median age at visit was 52 years (range 29-74). Patients were evaluated a median of 11 months (range 2-149) from their diagnosis of breast cancer. Of the 168/191 (88%) women who received chemotherapy, 22/168 (18%) had neoadjuvant treatment and 136/168 (91%) had any adjuvant treatment including chemotherapy, endocrine therapy and/or antibody therapy. Chemotherapy was anthracycline and taxane in 135/168 (70.7%), anthracycline without taxanes in 20/168 (11.9%), and taxane-based treatment in 13/168 (6.8%). At a median 5 months after finishing chemotherapy, numbness or tingling was reported in 79/168 (53%) patients who received taxane chemotherapy, and 17/168 (40%) of patients who did not receive taxanes. Moderate to severe numbness or tingling (score ≥4/10) occurred in 34% of patients who received taxanes and 26% of patients who did not receive taxanes. Mean score for numbness or tingling was 3.0 in patients receiving taxanes vs 2.4 in patients who did not receive taxanes (95% CI -0.57 to 1.76, p=0.32).
Conclusion: Patient-reported CIPN is more common in “real-world” breast cancer survivors than in clinical trials, with over half of patients experiencing any grade CIPN and a third with moderate to severe symptoms of CIPN five months after finishing taxane chemotherapy.