Arthralgia induced by endocrine treatment for breast cancer: A prospective study of serum levels of insulin like growth factor-I, its binding protein and oestrogens

Lintermans, Anneleen; Vanderschueren, Dirk; Verhaeghe, Johan; Asten, Kathleen Van; Jans, Ivo; Herck, Erik Van; Laenen, Annouschka; Paridaens, Robert; Billen, Jaak; Pauwels, Steven; Vermeersch, Pieter; Wildiers, Hans; Christiaens, Marie-Rose; Neven, Patrick

doi:10.1016/j.ejca.2014.08.012

Cited by 14 publications

(7 citation statements)

References 34 publications

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“…12 The severity of pain during AI treatment has also been evaluated in other studies. 8,[19][20][21][22] In the COM-PACT trial, arthralgia during the first year of anastrozole was assessed using a visual analog scale. As in the present study, there was a significant increase in pain values from baseline to 9 months of ET.…”

Section: Discussionsupporting

confidence: 92%

“…As in the present study, there was a significant increase in pain values from baseline to 9 months of ET. 8 Other studies have also demonstrated that patients with pain at baseline had significantly higher pain levels and worsening of preexisting symptoms during AI therapy, [19][20][21][22] a finding that is also in line with the present results.…”

Section: Discussionmentioning

confidence: 99%

“…Other trials have also reported on the influence of preexisting joint and muscle/limb pain on musculoskeletal pain syndrome during treatment with AIs . The severity of pain during AI treatment has also been evaluated in other studies . In the COMPACT trial, arthralgia during the first year of anastrozole was assessed using a visual analog scale.…”

Section: Discussionmentioning

confidence: 99%

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Preexisting musculoskeletal burden and its development under letrozole treatment in early breast cancer patients

Nabieva

Häberle

Brucker

et al. 2019

Intl Journal of Cancer

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One of the most common adverse events (AEs) occurring during treatment with aromatase inhibitors (AIs) is musculoskeletal pain. The aim of our study was to analyze the influence of preexisting muscle/limb pain and joint pain on the development of AI‐induced musculoskeletal AEs. Women eligible for upfront adjuvant endocrine therapy with letrozole were included in the PreFace study, a multicenter phase IV trial. During the first treatment year, they were asked to record musculoskeletal AEs monthly by answering questions regarding pain symptoms and rating the pain intensity on a numeric rating scale from 0 (no pain) to 10 (very strong pain). Pain values were compared using nonparametric statistical tests. Overall, 1,416 patients were evaluable. The average pain value over all time points in women with preexisting muscle/limb pain was 4.3 (median 4.3); in those without preexisting pain, it was 2.0 (median 1.7). In patients without preexisting muscle/limb pain, pain levels increased relatively strongly within the first 6 months (mean increase +0.9, p < 0.00001) in comparison with those with preexisting pain (mean increase +0.3, p < 0.001), resulting in a statistically significant difference (p < 0.00001) between the two groups. The development of joint pain was similar in the two groups. Women without preexisting muscle/limb pain or joint pain have the greatest increase in pain after the start of adjuvant AI therapy. Women with preexisting pain have significantly higher pain values. The main increase in pain values takes place during the first 6 months of treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Preexisting musculoskeletal burden and its development under letrozole treatment in early breast cancer patients

Nabieva

Häberle

Brucker

et al. 2019

Intl Journal of Cancer

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“…Patients with pain in the docetaxel group were significantly more often treated with adjuvant endocrine therapy compared with patients without pain, and 25% of patients with pain did not meet the predefined criteria for neuropathy. Owing to low estrogen levels and possible other unknown underlying mechanisms, adjuvant endocrine therapy is known to cause arthralgia, myalgia, joint stiffness, paresthesia, and carpal tunnel syndrome, 17 which may be misinterpreted as chemotherapy-induced neuropathic pain by both clinicians and patients. Recent studies have suggested that muscle and joint pain should be considered a part of the neuropathic syndrome, 9,11 but it is possible that these neuropathic-like symptoms are caused by endocrine therapy and are not a part of the CIPN syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…21,24 Most studies have pooled patients with different types of cancer treated with different neurotoxic agents, 1,11 which complicates the interpretation of the results, because the incidence and type of CIPN are dependent on the specific chemotherapeutic agent used. 15 Additional therapies, such as surgery, radiation therapy, and endocrine therapy, can cause other types of neuropathy and pain 17 and are used to varying degrees, but this has rarely been discussed.…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy-induced pain and neuropathy

Ventzel

Jensen²,

Jensen³

et al. 2016

Pain

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Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer therapy. This study evaluates symptoms of CIPN and CIPN-related pain and its influence on psychological functioning and potential predictors of chronic CIPN and pain. In this large prospective questionnaire study, 174 patients receiving adjuvant oxaliplatin or docetaxel were consecutively included. Patients were asked to complete a questionnaire with validated questions on peripheral neuropathy, pain, anxiety and depression, and quality of life at baseline, after the first cycle, halfway through therapy, and 1 year after baseline. Chronic CIPN symptoms (tingling and/or numbness) in the feet at 1-year follow-up were present in 63.6% of patients without preexisting neuropathy in the oxaliplatin group and in 44.8% in the docetaxel group, whereas pain in hands and feet was found in 31.3% and 35.1%, respectively. Both groups had significantly different pain profiles, and persistent pain in the docetaxel group was found to have effect on psychological function. Cumulative dose predicted oxaliplatin-induced neuropathy (P = 0.004), whereas endocrine therapy predicted peripheral pain in the docetaxel group (P = 0.04). There are important differences in acute neuropathic symptoms and chronic pain profiles in patients after oxaliplatin and docetaxel treatment. It is, however, important to recognize that chronic peripheral pain may be unrelated to neuropathy and can be caused by concomitant treatments. Future studies should focus on characterizing and distinguishing CIPN-related pain from other types of pain to determine the best outcome measures for trials on prevention or relief.

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Long‐term symptoms of polyneuropathy in breast and colorectal cancer patients treated with and without adjuvant chemotherapy

et al. 2020

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Background The aim of this study was to assess chemotherapy‐induced polyneuropathy (CIPN) 5 years after adjuvant chemotherapy in patients with breast and colorectal cancer. The association of CIPN with quality of life, anxiety, and depression was analyzed. Methods Of a set of 100 patients with breast cancer and of 74 with colorectal cancer who had undergone surgery and adjuvant chemotherapy in 2011‐2012, 80 and 52 patients alive, respectively, were included together with two reference groups of 249 breast cancer patients and 83 colorectal cancer patients who had undergone surgery only. All patients were sent a questionnaire on alcohol consumption, smoking habits, comorbidity, medicine consumption, and oxaliplatin‐specific questions, as well as the Michigan Neuropathy Screening Instrument questionnaire (MNSIq), the Douleur Neuropathique 4 Questions (DN4q), the EQ‐5D, and the Hospital Anxiety and Depression Scale. Possible polyneuropathy was defined as the presence of numbness and/or tingling in the feet, secondly as a score of ≥4 on the MNSIq. Possible painful polyneuropathy was defined as pain in both feet and a score ≥3 on the DN4q. Results The prevalence of possible polyneuropathy defined by numbness and/or tingling in the feet was 38.8% (28.1‐50.3) after adjuvant docetaxel and 57.7% (43.2‐71.3) after adjuvant oxaliplatin, with no significant difference from a previous 1‐year follow‐up ( P >.35). Fewer had possible polyneuropathy as defined by the MNSIq. Patients with possible polyneuropathy after adjuvant chemotherapy reported significantly lower quality of life than patients treated with surgery only. Conclusion Symptoms of polyneuropathy following adjuvant docetaxel and oxaliplatin persist 5 years after treatment and affect quality of life negatively.

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Arthralgia induced by endocrine treatment for breast cancer: A prospective study of serum levels of insulin like growth factor-I, its binding protein and oestrogens

Cited by 14 publications

References 34 publications

Preexisting musculoskeletal burden and its development under letrozole treatment in early breast cancer patients

Preexisting musculoskeletal burden and its development under letrozole treatment in early breast cancer patients

Chemotherapy-induced pain and neuropathy

Long‐term symptoms of polyneuropathy in breast and colorectal cancer patients treated with and without adjuvant chemotherapy

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