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. 2017 Sep 12;12(9):e0184322.
doi: 10.1371/journal.pone.0184322. eCollection 2017.

The Early Onset of Peripheral Neuropathy Might Be a Robust Predictor for Time to Treatment Failure in Patients With Metastatic Breast Cancer Receiving Chemotherapy Containing Paclitaxel

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Free PMC article

The Early Onset of Peripheral Neuropathy Might Be a Robust Predictor for Time to Treatment Failure in Patients With Metastatic Breast Cancer Receiving Chemotherapy Containing Paclitaxel

Ippei Fukada et al. PLoS One. .
Free PMC article

Abstract

Background: Paclitaxel plays a central role in chemotherapy for breast cancer. Peripheral neuropathy, a well-known toxicity with paclitaxel, may be of interest in predicting the efficacy of paclitaxel therapy for patients with metastatic breast cancer. We performed a retrospective analysis assessing whether the early occurrence of peripheral neuropathy (EPN) was a predictive marker for better efficacy in patients with metastatic breast cancer receiving chemotherapy containing paclitaxel.

Patients and methods: Between January 2000 and August 2008, we examined the records of 168 patients with metastatic breast cancer treated with paclitaxel in our hospital. EPN was defined as a symptom of Grade 2 or more during first three months of treatment. The overall response rate (ORR) and time to treatment failure (TTF) in each group were analyzed retrospectively.

Results: Of 168 patients with metastatic breast cancer who were treated with paclitaxel, EPN was documented in 101 patients (60.1%). The clinical benefit rate (CR, PR, and SD ≥ 6 months) was 72.3% in the EPN group and 49.3% in the non-EPN group (p = 0.002). The TTF of the EPN group (median 11.2 months, 95% CI: 9.5-12.9) was significantly longer than that of the non-EPN group (5.7 months, 95% CI: 4.6-6.8) (p<0.001). Multivariate analysis demonstrated that EPN (p<0.001), dose intensity of less than 70% (p<0.001), and the history of microtubule agents (p = 0.001) were the significant favorable prognostic factors for TTF.

Conclusion: The early onset of peripheral neuropathy might be a robust predictor for TTF in patients with metastatic breast cancer treated with paclitaxel.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Kaplan-Meier plots for TTF.
The TTF of the EPN group (median 11.2 months, 95% CI; 9.15–12.9) was significantly longer than that of the non-EPN group (5.7 months, 95% CI; 4.6–6.8) in all patients.
Fig 2
Fig 2. Kaplan-Meier plots for TTF according to subtypes.
Among the four subtypes, TTF was 10.0 months in the EPN group and 3.7 months in the non-EPN group in the luminal type (p = <0.001); 31.7 months in the EPN group and 17.5 months in the non-EPN group in the luminal-HER2 type (p = 0.270); 15.9 months in the EPN group and 9.5 months in the non-EPN group in the HER2 type (p = 0.029); and 6.1 months in the EPN group and 3.7 months in the non-EPN group of the triple negative type (p = 0.043).

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