Long-term Peripheral Neuropathy in Breast Cancer Patients Treated with Adjuvant Chemotherapy: NRG Oncology/NSABP B-30

Hanna Bandos, Joy Melnikow, Donna R. Rivera, Sandra M. Swain, Keren Sturtz, Louis Fehrenbacher, James L. Wade, Adam M. Brufsky, Thomas B. Julian, Richard G. Margolese, Edward C. McCarron, Patricia A. Ganz

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22 Scopus citations

Abstract

Background The long-term effects of chemotherapy are sparsely reported. Peripheral neuropathy (PN) is one of the most frequent toxicities associated with taxane use for the treatment of early-stage breast cancer. We investigated the impact of the three different docetaxel-based regimens and patient characteristics on long-term, patient-reported outcomes of PN and the impact of PN on long-term quality of life (QOL). Methods The National Surgical Adjuvant Breast and Bowel Project Protocol B-30 was a randomized trial comparing sequential doxorubicin (A) and cyclophosphamide (C) followed by docetaxel (T) (ACâ †'T), concurrent ACT, or AT in women with node-positive, early-stage breast cancer. The ACâ †'T group had a higher cumulative dose of T. PN was one of the symptoms assessed in a QOL substudy. Statistical methods included simple and mixed ordinal logistic regression and general linear models. All statistical tests were two-sided. Results Of 1512 patients, 41.9% reported PN two years after treatment initiation. Treatment with AT and ACT was associated with less severe long-term PN compared with ACâ †'T (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.35 to 0.58; OR = 0.59, 95% CI = 0.46 to 0.75). Preexisting PN, older age, obesity, mastectomy, and greater number of positive nodes were also associated with higher risk of long-term PN. Patients who reported worse PN symptoms at 24 months had statistically significantly worse QOL (P trend <.001). Conclusions The administration of docetaxel is associated with long-term PN. The lower rate of long-term PN in AT and ACT patients might be an important consideration in supporting choosing these therapies for individuals with preexisting neuropathic symptoms or other risk factors for neuropathy.

Original languageEnglish (US)
JournalJournal of the National Cancer Institute
Volume110
Issue number2
DOIs
StatePublished - 2017

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Bandos, H., Melnikow, J., Rivera, D. R., Swain, S. M., Sturtz, K., Fehrenbacher, L., Wade, J. L., Brufsky, A. M., Julian, T. B., Margolese, R. G., McCarron, E. C., & Ganz, P. A. (2017). Long-term Peripheral Neuropathy in Breast Cancer Patients Treated with Adjuvant Chemotherapy: NRG Oncology/NSABP B-30. Journal of the National Cancer Institute, 110(2). https://doi.org/10.1093/jnci/djx162