Obesity/Overweight and Lower Activity Level May Increase Risk of Taxane-Induced Neuropathy in Women With Invasive Breast Cancer
Greenlee et al found that obesity, overweight, and low levels of moderate-to-vigorous physical activity were associated with an increased risk of taxane-related peripheral neuropathy in women with invasive breast cancer, according to a study reported in the Journal of the National Cancer Institute.
Study Details
The study included 1,237 women enrolled in the Pathways Study cohort (N = 4,505) who received taxane therapy and had baseline Functional Assessment of Cancer Therapy–Taxane Neurotoxicity (FACT-NTX) data available. Baseline interviews evaluated body mass index (normal = < 25 kg/m2; overweight = 25–29.9 kg/m2; obese = ≥ 30 kg/m2), moderate-to-vigorous physical activity (low = < 2.5 h/wk; medium = 2.5–5 h/wk; high = > 5 h/wk) and fruit/vegetable intake (low = < 35 servings/wk; high = ≥ 35 servings/wk).
Baseline and 6-month interviews evaluated antioxidant supplement use (nonuser, discontinued, continued user, initiator). Chemotherapy-induced peripheral neuropathy was assessed at baseline, at 6 months, and at 24 months by FACT-NTX, with a 10% change considered clinically meaningful.
Patients had a mean age of 54 years, 65.6% were overweight or obese, 29.9% had low moderate-to-vigorous physical activity, 57.5% had low fruit/vegetable intake, and 9.5% used antioxidant supplements during treatment. Multivariate analysis for chemotherapy-induced peripheral neuropathy risk included baseline FACT-NTX, age, race, education, income, tumor stage, number of positive nodes, taxane drug, taxane schedule, prior taxane treatment, and number of comorbidities.
Risk of Peripheral Neuropathy
In multivariate analysis, increased chemotherapy-induced peripheral neuropathy was more likely in overweight (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.19–4.88) and obese patients (OR = 3.21, 95% CI =1.52–7.02) vs normal-weight patients at 24 months and less likely in patients with high vs low moderate-to-vigorous physical activity at 6 months (OR = 0.56, 95% CI = 0.34–0.94) and at 24 months (OR = 0.43, 95% CI = 0.21–0.87).
In an analysis restricted to the sensory neuropathy subscale, ≥ 10% worsening of symptoms was found at 24 months for overweight vs normal-weight patients (OR = 2.49, 95% CI = 1.43–4.39). Increased chemotherapy-induced peripheral neuropathy at 6 months was more likely among patients initiating antioxidant use during treatment vs nonusers (OR = 3.81, 95% CI = 1.82–8.04).
The investigators concluded: “Obesity and low [moderate-to-vigorous physical activity] were associated with [chemotherapy-induced peripheral neuropathy] in breast cancer patients who received taxane treatment.”
The study was supported by the National Cancer Institute and ASCO.
Heather Greenlee, ND, PhD, of Columbia University, is the corresponding author of the Journal of the National Cancer Institute article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
