1460P - A multi-centre study to investigate the natural history of taxane acute pain syndrome (TAPS) in patients receiving taxane-based chemotherapy for br...

Date 09 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Supportive measures
Presenter Ricardo Fernandes
Citation Annals of Oncology (2016) 27 (6): 497-521. 10.1093/annonc/mdw390
Authors R. Fernandes1, S. Mazzarello2, M.F. Ibrahim3, J. Hilton3, A. Joy4, M. Ong3, B. Hutton5, L. Vandermeer6, M. Clemons3
  • 1Department Of Medicine, Division Of Medical Oncology, The Ottawa Hospital Regional Cancer Centre, K1H 8L6 - Ottawa/CA
  • 2Ottawa Hospital Research Institute, University of Ottawa Faculty of Medicine, K1H 8L6 - Ottawa/CA
  • 3Department Of Medicine, Division Of Medical Oncology, The Ottawa Hospital Regional Cancer Centre, Ottawa/CA
  • 4Department Of Oncology, Division Of Medical Oncology, University of Alberta Cross Cancer Institute, Edmonton/CA
  • 5Department Of Epidemiology And Community Medicine, University of Ottawa Faculty of Medicine, Ottawa/CA
  • 6Ottawa Hospital Research Institute, University of Ottawa Faculty of Medicine, Ottawa/CA

Abstract

Background

Taxane acute pain syndrome (TAPS) is characterized by myalgia and arthralgia starting 24-48 hours after taxane-based chemotherapy and lasting up to 7 days. Despite its negative impact on patient quality of life, its characteristics and natural history remain poorly defined. This study evaluates persistence, severity and the impact of TAPS on quality of life (QoL).

Methods

Eligible patients with breast or prostate cancers commencing taxane-based chemotherapy completed the Functional Assessment of Cancer Therapy-Taxane (FACT-T), Brief Pain Inventory (BPI) questionnaires and a pain medication diary daily for 1 week after each chemotherapy infusion. TAPS was defined through myalgias and arthralgias on questionnaires.

Results

From March to December 2015, of 52 patients enrolled 25 completed the study. 66% of breast patients reported TAPS. TAPS started 24-72 (range 24-96) hours after treatment infusion reaching a peak by day 3 (range 1-5). TAPS was more common in the legs and back. Dose reductions, delays or treatment discontinuation were not required due to TAPS. Medications used to treat TAPS included opioids (n = 5) and NSAIDs (n = 9). There was negative effect of pain on QoL in pain scores at baseline in comparison with the final infusion cycle (mean change in “BPI worst pain” score was +1.61 and FACT-T score was -6.9, with p-values 0.014 and 0.017, respectively).

TAPS characteristics

TC (n = 10) FEC-D (n = 2) Single agent Palcitaxel(N = 9) AC-P or AC-D (n = 3)
TAPS Incidence 80% 50% 22% 100%
Growth factor use (n) 7 1 0 1
Taxane Dosing at 100 mg/m2 No Yes No Yes
Oral Steroids use (n) 8 1 0 2

TC - cyclophosphamide plus docetaxel; FEC-D - 5-fluorouracil-epirrubicin-cyclophosphamide followed by docetaxel; AC-D - doxorubicin-cyclophosphamide followed by docetaxel; AC-T - doxorubicin-cyclophosphamide followed by paclitaxel

Conclusions

TAPS is a common toxicity and associated with a negative impact on QoL. Further data will help define predisposing risk factors. Prospective patient reported outcome assessments are crucial to individualize treatment strategies and to improve management of TAPS.

Clinical trial identification

NCT02362087

Legal entity responsible for the study

Ottawa Hospital Regional Cancer Centre

Funding

Ottawa Hospital Regional Cancer Centre (Internal)

Disclosure

All authors have declared no conflicts of interest.