Peripheral Neuropathy More Severe With Taxol Versus Taxotere
Peripheral neuropathy is a common side effect of two chemotherapy medicines used to treat breast cancer — Taxol (chemical name: paclitaxel) and Taxotere (chemical name: docetaxel) — and is more severe in people receiving Taxol, according to a study.
The research was presented on June 5, 2023, at the American Society of Clinical Oncology (ASCO) Annual Meeting. Read the abstract of “Chemotherapy induced peripheral neuropathy (CIPN) due to paclitaxel versus docetaxel in patients with early-stage breast cancer receiving taxane therapy: SWOG S1714.”
About peripheral neuropathy
Neuropathy is the term used to describe the pain, tingling, or numbness caused by damage to nerves. Your peripheral nervous system is made up of the nerves that send signals from the brain and spinal cord to other — peripheral — parts of your body. Peripheral neuropathy usually starts in your hands and feet, but can affect other parts of your body.
Chemotherapy is a common cause of peripheral neuropathy, and it’s called chemotherapy-induced peripheral neuropathy.
Taxane chemotherapy and peripheral neuropathy
Taxane chemotherapy medicines are commonly used to treat early-stage breast cancer. Taxol and Taxotere are two of the most commonly used taxanes. Taxol and Taxotere are usually combined with other chemotherapy medicines.
Peripheral neuropathy is one of the most common side effects of taxane chemotherapy. It can develop any time after your start chemotherapy and may get worse as treatment continues.
About the study
In this study, the researchers wanted to provide more information on how common and severe taxane-based chemotherapy-induced peripheral neuropathy is.
Currently, the risk factors for neuropathy are:
older age
pre-existing neuropathy
previously receiving Taxol
The overarching goal of this study is to develop a model that can help doctors better predict who has the highest risk of peripheral neuropathy, as well as create personalized care plans.
Overall, the study included 1,336 people diagnosed with stage I to stage III breast cancer, non-small cell lung cancer, or ovarian cancer.
All the people were scheduled to receive taxane-based chemotherapy.
For this analysis, the researchers only looked at information from the 1,106 people diagnosed with early-stage breast cancer.
Among the people with breast cancer:
half were older than 54.8 years and half were younger
99.3% were women
72.3% were white
11.3% were Black
11.1% were Hispanic or Latino
4.6% were Asian
55.6% received Taxol
44.3% received Taxotere
The researchers assessed peripheral neuropathy five times for this analysis:
before chemotherapy started
four weeks after chemotherapy started
eight weeks after chemotherapy started
12 weeks after chemotherapy started
24 weeks after chemotherapy started
The people in the study also completed a questionnaire to assess their personal perception of peripheral neuropathy. The questionnaire scores symptoms on a 100-point scale; a higher score means symptoms are worse. The researchers defined a score increase of eight points or more as a clinically meaningful worsening of symptoms.
At the 24-week assessment, the percentage of people with score increases of eight or more points was higher in the Taxol group than in the Taxotere group:
50.2% of people receiving Taxol had a score increase of eight or more points
40.5% of people receiving Taxotere had a score increase of eight or more points
The researchers noted that at nearly every assessment through 24 weeks, people receiving Taxol had more neuropathy than people receiving Taxotere.
“In this diverse cohort of patients with breast cancer, the frequency of [chemotherapy-induced peripheral neuropathy] was higher than expected for both paclitaxel and docetaxel and more severe in patients receiving paclitaxel,” the researchers concluded. “Long-term follow-up will better characterize the differences in the trajectory of [chemotherapy-induced peripheral neuropathy] between paclitaxel and docetaxel.”
What this means for you
If you’ve been diagnosed with early-stage breast cancer and are scheduled to start a taxane-based chemotherapy regimen, this study gives you some important information.
Taxol seems to cause more severe peripheral neuropathy than Taxotere. If you are at higher risk for the condition, you may want to ask your doctor if you can receive Taxotere.
Treatments for peripheral neuropathy include:
oral medicines
pain patches
topical creams
A study led by Marisa Weiss, MD, founder and chief medical officer of Breastcancer.org, found that a specific cannabis product helped ease peripheral neuropathy caused by chemotherapy.
Listen to The Breastcancer.org Podcast episode featuring Dr. Weiss discussing the results.
— Last updated on August 16, 2024 at 7:02 PM