Predictors of chemotherapy-induced peripheral neuropathy among breast cancer patients treated with taxanes.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 90-90 ◽  
Author(s):  
Nellowe Candelario ◽  
Supakanya Wongrakpanich ◽  
Mark S. Morginstin
Keyword(s):  
Breast Cancer ◽  
Peripheral Neuropathy ◽  
Alcohol Use ◽  
Cancer Patients ◽  
Statistical Significance ◽  
Metastatic Breast ◽  
Smoking History ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Her2 Positivity

90 Background: Breast cancer is one of the most common types of cancer. Taxanes are used to treat both early and metastatic breast cancer. Chemotherapy-induced peripheral neuropathy (CIPN) is its most common dose-limiting side effect that is debilitating and that could alter the treatment outcomes. This study aims to assess the predictors in the development and severity of CIPN. Methods: A retrospective review of 229 breast cancer patients was done to identify if age, BMI, race, smoking history, alcohol use, diabetes, chronic kidney disease (CKD), estrogen (ER), progesterone receptor (PR) and HER2 status, type and dose of taxane were predictors in the development and severity of CIPN. Patients who had incomplete data and baseline neuropathy were excluded from the study. Severity of peripheral neuropathy was graded from 1 to 4. Pearson Chi-square and T-test were done to determine the presence of statistical difference in the development and severity of CIPN among the above predictors. Odds ratio was computed using logistic regression analysis. Results: Among the 229 patients in this study, 158 (69%) developed neuropathy, 90 (57%) of whom had grade 1 neuropathy. Majority of the subjects in this study were African American (75.1%). Age, BMI, race, smoking, alcohol use, CKD and diabetes did not show any statistical significance as predictors of development and severity of CIPN (p > 0.05). Patients with ER+/PR- and ER+/PR+ had lower odds of developing neuropathy with OR 0.36 (p = 0.006) and 0.44 (p = 0.026) respectively. HER2 positivity was associated with higher chances of neuropathy (OR 2.11, p = 0.028). Paclitaxel was associated with higher chances of neuropathy compared to docetaxel (OR 2.89, p = 0.02). Dose of paclitaxel did not show any difference in the occurrence of CIPN. Those treated with paclitaxel had more severe neuropathy (p = 0.04). Conclusions: Positive ER and PR receptors have lower chances of developing CIPN. HER2 positivity is a predictor in the development of neuropathy. Paclitaxel is more neurotoxic than docetaxel. Age, race, BMI, smoking, alcohol use, diabetes and CKD were not predictors in the development and severity of CIPN.

Utilization of anti-HER2 regimens among HER2-positive metastatic breast cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 282-282
Author(s):  
Sandhya Mehta ◽  
Jinlin Song ◽  
Melissa Pavilack ◽  
Jipan Xie ◽  
Xiaoyu Nie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Targeted Therapies ◽  
Metastatic Breast ◽  
Cancer Registries ◽  
Additional Treatment ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Her2 Positive

282 Background: HER2-positive (+) metastatic breast cancer (mBC) has a poor prognosis and many patients require multiple lines of HER2 targeted regimens. This study aims to examine the treatment sequencing of anti-HER2 regimens for HER2+ mBC among Medicare beneficiaries. Methods: A retrospective study was conducted using linked 1999-2016 Surveillance, Epidemiology, and End Results (SEER) cancer registries and Medicare claims. Adults patients who had mBC diagnosis, HER2+ status documented in SEER or claims of ≥1 anti-HER2 drug, continuous enrollment in Medicare from the date of mBC diagnosis until end of study period/death, and 2 anti-HER2 regimens with or without chemotherapy (Ch) or hormonal therapy (HT) were included. Discontinuation of anti-HER2 regimen was defined as the absence of claims for all anti-HER2 drugs for >60 days, or initiation of a different anti-HER2 drug. Re-initiation of the same regimen after >60 days was considered as a new regimen. The first two anti-HER2 regimens and subsequent therapies were summarized. Results: 804 patients with 2 anti-HER2 regimens were included. Trastuzumab (T) based regimen (defined as: T±Ch/HT; without other anti-HER2 drugs) was the most common 1st regimen (82%), followed by T+ pertuzumab (P) (14%) and lapatinib (L) (3%). For the 2nd regimen, T (52%) was most common, followed by T+P (18%), L (11%), trastuzumab emtansine (T-DM1) (11%) and T+L (7%). After a 2nd regimen, 578 (72%) initiated a subsequent therapy, with over half switching to non-targeted therapies [52%; HT alone (35%), Ch±HT (17%)] followed by T (17%), T-DM1 (12%) and T+P (7%). Among those with subsequent therapy, 2 T-based regimens followed by HT alone (21%) was the most common sequence. After the 1st regimen, 52% patients reused the same anti-HER2 drugs in the 2nd regimen, 21% added another anti-HER2 drug and 27% switched to a different anti-HER2 regimen. After the 2nd regimen, 14% reused anti-HER2 drugs and 6% added another anti-HER2 drug, 25% switched to a different anti-HER2 regimen; 15% reused anti-HER2 drugs from the 1st regimen. Conclusions: Trastuzumab based regimen was the mainstay of anti-HER2 drug regimens during the study timeframe. Despite availability of multiple anti-HER2 drugs, reuse of prior anti-HER2 drugs and switching to non-targeted therapies alone were common after using 2 anti-HER2 regimens. These findings underscore the unmet needs in later lines of therapy. Recently approved anti-HER2 agents may provide additional treatment options for pre-treated HER2+ metastatic breast cancer patients.

Factors associated with mortality after breast cancer metastasis.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 174-174
Author(s):  
S. Y. Jung ◽  
M. Q. Rosenzweig ◽  
S. M. Sereika ◽  
F. Linkov ◽  
A. Brufsky ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Cancer Metastasis ◽  
Cox Regression ◽  
Metastatic Breast ◽  
Breast Cancer Metastasis ◽  
Her2 Status ◽  
Breast Cancer Patients

174 Background: It is generally accepted that patients with breast cancer metastases have poor survival. Metastatic breast cancer patients can be considered a heterogeneous population with a varied clinical course, which underscores the need for accurate prediction of survival based on prognostic factors. The purpose of the present study was to identify factors related to survival in breast cancer patients after diagnosis with metastatic disease. Methods: A total of 557 patients with breast cancer metastasis diagnosis seen at one large urban practice have been followed up between January 1, 1999 and June 30, 2008. Demographic, tumor characteristics, clinical factors as predictors of survival were analyzed using Cox regression model. Results: The median survival length was 40 months (range 1-114 months) with 269 (48.3%) alive and 288 (51.7%) dead. This study demonstrated that hypertension, estrogen receptor (ER) and/or progesterone receptor (PR) status, human epidermal growth factor receptor-2 (HER2) status, number of metastatic sites, and body mass index (BMI) at diagnosis with metastatic breast cancer were the most relevant prognostic factors for survival after metastasis. Conclusions: Findings of this study may form a foundation for the corpus of knowledge explaining the outcome differences in treatment of patients with metastatic breast cancer, potentially helping to create tailored counseling and personalized treatment approaches for this vulnerable group. [Table: see text]

scholarly journals Predictors of the development of nab-paclitaxel-induced peripheral neuropathy in breast cancer patients: Sub-analysis of a prospective, self-controlled trial

2021 ◽  
Author(s):  
YUKO KANBAYASHI ◽  
Koichi Sakaguchi ◽  
Takeshi Ishikawa ◽  
Yoshimi Ouchi ◽  
Katsuhiko Nakatsukasa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Compression Therapy ◽  
Smoking History ◽  
Comparable Efficacy ◽  
Breast Cancer Patients ◽  
Number Of Patients

Abstract Purpose In a previous study, we showed that cryotherapy and compression therapy have comparable efficacy in preventing nab-paclitaxel-induced peripheral neuropathy. However, even with cryotherapy or compression therapy, there were patients with National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 grade ≥ 2 and/or Patient Neurotoxicity Questionnaire (PNQ) grade ≥ D peripheral neuropathies. Therefore, a sub-analysis was performed to identify predictors of nab-paclitaxel-induced peripheral neuropathy. Methods The clinical data in this sub-analysis were the data of 38 breast cancer patients receiving chemotherapy with nanoparticle albumin-bound paclitaxel (nab-PTX) at our outpatient chemotherapy center from August 2017 to March 2019. The number of patients was analyzed assuming that there were data for 76 hands. Variables related to the development of nab-PTX-induced peripheral neuropathy were used for regression analysis. Multivariate ordered logistic regression analysis was performed to identify predictors for the development of nab-PTX-induced peripheral neuropathy. Results Significant factors included smoking history [odds ratio (OR) = 4.64, 95% confidence interval (CI) = 1.60–13.5; P = 0.0048] with neuropathy evaluated by CTCAE, body mass index (BMI) (OR = 1.13, 95% CI = 1.01–1.26; P = 0.039) with neuropathy evaluated by PNQ (sensory), and smoking history (OR = 3.80, 95% CI = 1.40–10.30; P = 0.0087) and age (OR = 1.06, 95% CI = 1.01–1.11; P = 0.012) with neuropathy evaluated by PNQ (motor). Conclusions Smoking history, BMI and age were identified as significant predictors of the development of nab-PTX-induced-peripheral neuropathy.

Evaluation of Ile655Val HER2 polymorphism associated with cardiac toxicity following the administration of trastuzumab in women with breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 634-634
Author(s):  
Caroline Diorio ◽  
Julie Lemieux ◽  
Marc-Andre Cote ◽  
Louise Provencher ◽  
Corinne Nadeau-Larochelle ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Cardiac Toxicity ◽  
Statistical Significance ◽  
Metastatic Breast ◽  
Fisher Exact Test ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Genotype Frequencies

634 Background: Trastuzumab is well tolerated without major side effects except for cardiac toxicity. Although a number of clinical parameters have been associated with trastuzumab-associated cardiac toxicity (TACT), there is some indication that genetic variation of the HER2 gene may play a toxic role in a population of metastatic breast cancer patients. However, this finding needs confirmation and we looked at a population of non-metastatic breast cancer. This study aimed to evaluate the association between cardiac toxicity and HER2 [Ile655Val] polymorphism in non-metastatic breast cancer patients treated with trastuzumab. Methods: The Ile655Val HER2 polymorphism was assessed in 73 women using TaqMan technology. For this study, the genotyping was performed using DNA extracted from normal breast tissue located at more than 1 cm of any other lesions. Charts review was used to collect information on TACT which was defined as any decline in LVEF > 10 % from the baseline to < 55 % or a decline in LVEF > 5 % to < 50 % (lower limit of normal). The Fisher exact test was used to evaluate the association between cardiac toxicity and HER2 polymorphism. Results: No deviation from the Hardy-Weinberg equilibrium has been observed for the allele and genotype frequencies. The distribution of HER2 polymorphism was 3 Val/Val (4%), 18 Ile/Val (25%) and 52 Ile/Ile (71%). In this population, 19% (14/73) developed a cardiac toxicity. We found that 29% (6/21) of Ile/Val or Val/Val carriers compared to 15% (8/52) of Ile/Ile carriers showed TACT, but this association did not reach statistical significance (P = 0.21). Conclusions: HER2 Ile655Val polymorphism may be an efficient marker of TACT considering this tendency with this small cohort of patients. Larger sample is needed to strengthen this conclusion, since this result may influence on prescribing decision for adjuvant chemotherapy and anti-HER2 therapy in HER2 positive patients.

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