Toxicities, dose reduction and delay of docetaxel and paclitaxel chemotherapy in breast cancer without distant metastases

Abstract

The patients in the ACP group experienced more frequent peripheral neuropathy (P=0.025), nausea (P=0.033) than those in the TAC group. Febrile neutropenia was significant in TAC (P=0.001). Increasing age was associated with an increased risk of anemia (P=0.004), fatigue (P=0.009) and pain (P=0.003), and a decreasing body mass index was associated with an increased risk of febrile neutropenia (P=0.009). Dose reduction and delay occurred due to febrile neutropenia and an increase in aspartate aminotransferase (AST)/alanine aminotransferase (ALT). The dose reduction was only significant in the TAC group (P= 0.001). A taxane-based regimen should be chosen for breast cancer patients based on the pharmacokinetics, dosing schedule, clinical activity and toxicity profile that best meet the patient's therapeutic needs and quality of life.

Neutropenia: occurrence and management in women with breast cancer receiving chemotherapy

“…Such practices can have a significant impact on the survival results, in the same way that they reduce the intensity of the dose received. However, in order to obtain the maximum benefit from the chemotherapy treatment, the maintenance of the total dose calculated must be maintained as an important response factor to the treatment, as for every seven days of delay in the chemotherapy treatment, there is a reduction of approximately 5% of the intensity of the dose ( 6 ) .…”

“…The management of this chemotherapy-induced AE is administered in different ways in clinical practice. In general, the strategies are limited to the reduction of the dose of the chemotherapy agents, postponement between the cycles, and the use of colony-stimulating factors, although these are considered common clinical practices during the treatment of patients with primary breast cancer who present AEs, such as episodes of neutropenia ( 6 ) .…”

Hematologic Toxicities and its Determinants among Breast Cancer Patients Treated with Doxorubicin-Cyclophosphamide Followed by Paclitaxel Regimen in Cancer Centers: Retrospective Cohort Study

“…However, they are associated with diverse hematologic toxicities of varying intensity such as chemotherapy induced neutropenia (CIN), febrile neutropenia(NF), anemia (CIA), and thrombocytopenia (CIT), among others. For example, previous studies identi ed that the magnitude of CIN in breast cancer patients treated with AC-T regimen ranged from 5 to 100% (3,5,(7)(8)(9)(10), NF (4.1 to 29.5%) (3,7,(10)(11)(12)(13), CIA (2.8-97.1%) (5,7,8,(14)(15)(16)(17)(18)(19)(20), and CIT (1-42.9%) (5,7,8,14,21). Moreover, around 70% of cancer patients were also developed short and long-term systemic complications (22).…”

“…Studies identi ed that increased age, bone metastasis and Eastern cooperative oncology group performance status (ECOG) ≥ 1 were factors associated with CIN (9,10). Wherase decrease body mass index (BMI), advanced stage of cancer (stage 2,3,4), disease comorbidity and presence of grade 4 neutropenia were facors associated with NF (7,11,23). On the otherhand, distant metastasis, increasing age and cycles of chemotherapy, low baseline hemoglobin (HGB) level, poor performance status, surgical treatment and advanced stage of cancer were factors associated with CIA (7,(15)(16)(17)(18)(19).…”

Non-viral nanocarriers for siRNA delivery in breast cancer

“…Shortcomings of conventional chemotherapy include (1) severe side effects due to lack of targeting. For example, combined treatment with adriamycin, cyclophosphamide and paclitaxel (ACP group) frequently induces peripheral neurophathy [3]. Paclitaxel kills without distinguishing carcinoma cells from normal cells; (2) conventional chemotherapy relies on excipients to solubilize the drugs, failing to promote specific accumulation of drugs within the tumor to enhance bioavailability.…”