Results from the ECOG-ACRIN EAZ171 trial—reported in the Journal of Clinical Oncology by Schneider et al—showed that germline predictors of taxane-induced peripheral neuropathy were not associated with an increased risk of taxane-induced peripheral neuropathy in Black women with early-stage breast cancer receiving taxanes either neoadjuvantly or adjuvantly.
As stated by the investigators: “Black women experience higher rates of taxane-induced peripheral neuropathy compared with White women when receiving adjuvant once-weekly paclitaxel for early-stage breast cancer, leading to more dose reductions and higher recurrence rates. EAZ171 aimed to prospectively validate germline predictors of taxane-induced peripheral neuropathy and compare rates of taxane-induced peripheral neuropathy and dose reductions in Black women receiving (neo)adjuvant once-weekly paclitaxel or once-every-3-weeks docetaxel for early-stage breast cancer.”
Study Details
A total of 249 women of African descent were enrolled into the U.S. multicenter trial between June 2019 and March 2022. Of these, 126 received once-weekly paclitaxel and 123 received once-every-3-weeks docetaxel. A total of 240 patients had genotyping available to determine genetic risk; 91 patients (77.8%) in the paclitaxel group and 87 (73.7%) in the docetaxel group were classified as high risk. The incidence of physician-reported grade 2 to 4 taxane-induced peripheral neuropathy was compared between high- vs low-risk genotypes and between once-weekly paclitaxel vs once-every-3-weeks docetaxel within 1 year.
Key Findings
Physician-reported grade 2 to 4 taxane-induced peripheral neuropathy occurred in 47% of patients with a high-risk genotype vs 35% of those with a low-risk genotype among those receiving once-weekly paclitaxel (P = .27) and in 28% vs 19% (P = .47) among those receiving once-every-3-weeks docetaxel.
The incidence of grade 2 to 4 taxane-induced peripheral neuropathy was significantly higher in the once-weekly paclitaxel group vs the once-every-3-weeks docetaxel group (45% vs 29%, P = .02). More patients in the once-weekly paclitaxel group required dose reductions due to taxane-induced peripheral neuropathy (28% vs 9%, P < .001).
The investigators concluded, “Germline variation did not predict risk of taxane-induced peripheral neuropathy in Black women receiving (neo)adjuvant once-weekly paclitaxel or once-every-3-weeks docetaxel. Once-weekly paclitaxel was associated with significantly more grade 2 to 4 taxane-induced peripheral neuropathy and required more dose reductions than once-every-3-weeks docetaxel.”
Bryan P. Schneider, MD, of the Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the ECOG-ACRIN Cancer Research Group and the National Cancer Institute. For full disclosures of the study authors, visit ascopubs.org.
