Association of Met-BDNF allele with pre-existing peripheral neuropathy in breast cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21702-e21702
Author(s):  
David Azoulay ◽  
Anca Leibovici ◽  
Rivka Sharoni ◽  
Hadassah Goldberg
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Sanger Sequencing ◽  
Treatment Protocol ◽  
Breast Cancer Patients ◽  
Allelic Discrimination ◽  
Extended Study

e21702 Background: We previously published preliminary results suggesting an association between the met-BDNF allele and vulnerability to paclitaxel-induced peripheral neuropathy (PIPN) in breast cancer patients. Here we present updated data obtained from our extended study. Methods: 35 patients; 34 women (33 with breast cancer and 1 with ovarian cancer) and one man (breast cancer) completed their follow-up. Peripheral neuropathy (PN) was assessed at diagnosis and along the treatment protocol, using the reduced version of Total Neuropathy Score (TNSr). Patients with TNSr≥2 at diagnosis were determined with pre-existing PN (Pre-PN). Allelic discrimination of BDNF polymorphism (rs6265) was determined by Sanger sequencing. Results: BDNF genotype Val/Val was found in 20 patients (57.14%), Val/Met in 15 patients (42.86%). No patient had the Met/Met genotype. 10 patients (28.57%) were diagnosed with Pre-PN, 3 of them with diabetic-related neuropathy. A higher incidences of the Met-BDNF allele was found in patients with Pre-PN as compared to patients with no Pre-PN (7/10 (70%) vs. 8/25 (32%) Val/Met in Pre-PN and no Pre-PN respectively, prob > ChiSq < 0.05). The three patients with diabetic related Pre-PN were genotyped Met-BDNF. The maximal TNSr scores developed by each patient during follow-up were higher in Met-BDNF patients compare to Val/Val patients. (Maximal TNSr mean ± SEM in Val/Val 4.80±0.62 vs. 7.73±1.34 in Val/Met BDNF, prob < t 0.04). No difference in the maximal TNSr scores between Met-BDNF and Val/Val patients were shown after excluding the patients with Pre-PN (Maximal TNSr mean ± SEM in Val/Val 5.05±0.78 vs. 5.25±0.62 in Val/Met BDNF, prob < t 0.44). Conclusions: Our data demonstrate an association between met-BDNF and Pre-PN. Higher maximal TNSr scores in our met-BDNF patients is generally the consequence of their higher Pre-PN.

Chemotherapy-induced peripheral neuropathy as a predictor of neuropathic pain in breast cancer patients previously treated with paclitaxel

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20505-e20505
Author(s):  
C. C. Reyes-Gibby ◽  
P. Morrow
Keyword(s):  
Breast Cancer ◽  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Significant Proportion ◽  
Sensory Neuropathy ◽  
Breast Cancer Patients ◽  
Comorbid Conditions ◽  
Duration Of Treatment

e20505 Background: Neuropathic pain (NP) remains difficult to control for a significant proportion of patients with cancer. Chemotherapy induced peripheral neuropathy (CIPN) is postulated as an initial stage to the development of NP. Among breast cancer patients, taxanes, platinum agents, and vinca alkaloids are most likely to cause NP. The purpose of this study was to assess the extent to which those who experienced CIPN (NCI toxicity criteria ≥ grade 2 sensory neuropathy) during paclitaxel chemotherapy were at risk of developing chronic NP, controlling for disease- and treatment-related variables (e.g., stage of disease, location of tumor chemotherapy and other cancer therapies, dose of chemotherapy and duration of treatment), clinical health status (e.g., comorbid conditions), and sociodemographic characteristics (e.g., age, race). Methods: We conducted a follow-up survey of breast cancer patients who previously participated in clinical trials for paclitaxel. Patients were asked if they have ever been diagnosed by the physician or healthcare provider for NP during the survey. Clinical trial data (NCI Toxicity, cummulative dose) were abstracted from a clinical database. Results: Of the 430 potential respondents, 240 responded to the survey. Mean follow-up time was 9.5 years (SD=2.1). Sixty three percent of the respondents had grade 2 or greater sensory neuropathy during their previous treatment with paclitaxel. Follow-up data showed that 18% (43/240) were subsequently diagnosed by their physician to have NP. Logistic regression analysis showed that those with CIPN during the trial were 3 times more likely to having been diagnosed with NP (OR=3; 95%CI=1.2; 7.2; p<0.001), which persisted in the multivariable model. Other variables found to be associated with NP included cummulative dose of paclitaxel, and comorbid conditions such as diabetes and osteoarthritis. Patients with NP reported twice as many visits to their health care provider (p=0.028); had taken more prescription (50% versus 19%; p=0.0001) for pain relative to those without NP. Conclusions: We provide empirical evidence on the importance CIPN as a risk factor for NP in breast cancer patients.Prospective studies with larger cohorts are needed to validate our findings. No significant financial relationships to disclose.

scholarly journals Metformin improves the outcomes in Chinese invasive breast cancer patients with type 2 diabetes mellitus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tianli Hui ◽  
Chao Shang ◽  
Liu Yang ◽  
Meiqi Wang ◽  
Ruoyang Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cancer Patients ◽  
Invasive Breast Cancer ◽  
Breast Cancer Patients ◽  
Diabetes Group ◽  
Metformin Group

AbstractEarly reports indicate that metformin, a clinical drug administered to treat type 2 diabetes mellitus (T2DM), was found to be associated with a better prognosis of cancer. The objective of this study was retrospectively analyzed the effect of metformin on the outcomes of Chinese breast cancer patients with T2DM. A total of 3757 primary invasive breast cancer patients who underwent surgery from January 2010 to December 2013 were enrolled. According to the medication treatment, all the patients were divided as non-diabetes group, metformin group and insulin group. The follow-up data for disease-free survival (DFS) and overall survival (OS) were obtained from 3553 patients (median follow up of 85 months) and estimated with the Kaplan–Meier method followed by a log-rank test. Multivariate Cox proportional hazards regression model was applied. The results showed that there was a significant survival difference among non-diabetes group, metformin group and insulin group, 5-year DFS was 85.8%, 96.1%, 73.0%, and 5-year OS was 87.3%, 97.1%, 73.3% respectively (P < 0.05). Prognostic analysis showed metformin was significantly associated with better DFS and OS. Our results suggested that metformin may have a good effect on the survival of invasive breast cancer patients with T2DM.

scholarly journals The impact of hyperbaric oxygen therapy on late radiation toxicity and quality of life in breast cancer patients

2021 ◽  
Author(s):  
Marilot C. T. Batenburg ◽  
Wies Maarse ◽  
Femke van der Leij ◽  
Inge O. Baas ◽  
Onno Boonstra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Oxygen Therapy ◽  
Radiation Toxicity ◽  
Breast Pain ◽  
Breast Cancer Patients

Abstract Purpose To evaluate symptoms of late radiation toxicity, side effects, and quality of life in breast cancer patients treated with hyperbaric oxygen therapy (HBOT). Methods For this cohort study breast cancer patients treated with HBOT in 5 Dutch facilities were eligible for inclusion. Breast cancer patients with late radiation toxicity treated with ≥ 20 HBOT sessions from 2015 to 2019 were included. Breast and arm symptoms, pain, and quality of life were assessed by means of the EORTC QLQ-C30 and -BR23 before, immediately after, and 3 months after HBOT on a scale of 0–100. Determinants associated with persistent breast pain after HBOT were assessed. Results 1005/1280 patients were included for analysis. Pain scores decreased significantly from 43.4 before HBOT to 29.7 after 3 months (p < 0.001). Breast symptoms decreased significantly from 44.6 at baseline to 28.9 at 3 months follow-up (p < 0.001) and arm symptoms decreased significantly from 38.2 at baseline to 27.4 at 3 months follow-up (p < 0.001). All quality of life domains improved at the end of HBOT and after 3 months follow-up in comparison to baseline scores. Most prevalent side effects of HBOT were myopia (any grade, n = 576, 57.3%) and mild barotrauma (n = 179, 17.8%). Moderate/severe side effects were reported in 3.2% (n = 32) of the patients. Active smoking during HBOT and shorter time (i.e., median 17.5 vs. 22.0 months) since radiotherapy were associated with persistent breast pain after HBOT. Conclusion Breast cancer patients with late radiation toxicity reported reduced pain, breast and arm symptoms, and improved quality of life following treatment with HBOT.

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