Risk factor analysis for taxane-associated acute pain syndrome under the dexamethasone prophylaxis

• Published in: Supportive care in cancer Vol. 29; no. 12; pp. 8059 - 8067
• Main Authors: Saito, Yoshitaka, Takekuma, Yoh, Kobayashi, Masaki, Sakamoto, Tatsuhiko, Yamashita, Hiroko, Sugawara, Mitsuru
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2021; Springer; Springer Nature B.V
• Subjects: Acute pain; Acute Pain - chemically induced; Adjuvant treatment; Antineoplastic Combined Chemotherapy Protocols; Breast cancer; Breast Neoplasms - drug therapy; Bridged-Ring Compounds; Cancer; Chemotherapy; Dexamethasone; Dexamethasone - therapeutic use; Factor Analysis, Statistical; Female; Health risks; Humans; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Neurological disorders; Nursing; Nursing Research; Oncology; Original Article; Paclitaxel; Pain; Pain Medicine; Pertuzumab; Rehabilitation Medicine; Retrospective Studies; Risk Factors; Side effects; Steroids; Taxoids - adverse effects; Dexamethasone (DEX); Myalgia; Arthralgia; Taxane-associated acute pain syndrome (T-APS); Paclitaxel; Docetaxel
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-021-06342-2

Purpose
Taxane-associated acute pain syndrome (T-APS) reportedly occurs in approximately 70% of patients undergoing therapy. We have previously reported that additional dexamethasone (DEX) administration attenuates T-APS. The aim of this study was to reveal risk factor(s) associated with the incidence of T-APS under prophylactic DEX administration.
Methods
In total, 143 patients with breast cancer who received docetaxel (75 mg/m
2
) or paclitaxel (175 mg/m
2
)-containing treatment regimens were enrolled. DEX (4–8 mg) was orally administered on days 2–4. Risk factors for the incidence of ≥ G2 and all-grade T-APS, as well as T-APS incidence between taxane-containing regimens in the first cycle, were retrospectively evaluated.
Results
Approximately 90% of the patients received taxanes for adjuvant or neoadjuvant chemotherapy. Overall, 55% of patients administered 4 mg DEX, whereas 45% received 8 mg DEX. Pegfilgrastim was administered in 27% of patients. Incidence of ≥ G2 and all-grade T-APS was 23.8%, and 69.2%, respectively. Univariate and multivariate analyses revealed that administration of pegfilgrastim is an independent risk factor for the incidence of ≥ G2 and all-grade T-APS; age younger than 55 years is also a risk factor for all-grade T-APS. Moreover, the incidence of ≥ G2 and all-grade T-APS was 45.5% and 81.8% in a paclitaxel regimen, and 22.0% and 68.2% in docetaxel-including regimens, respectively, revealing increased tendency with paclitaxel administration, with no significant differences.
Conclusion
Pegfilgrastim co-administration is an independent risk factor for ≥ G2 and all-grade T-APS, and age younger than 55 years is a risk factor of all-grade T-APS under prophylactic DEX administration.