533P - Docetaxel induced cutaneous toxicity in breast cancer patients

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Cytotoxic agents
Complications/Toxicities of treatment
Presenter Chandan Das
Citation Annals of Oncology (2016) 27 (suppl_9): ix170-ix176. 10.1093/annonc/mdw599
Authors C.K. Das, A. Garg, A. Gogia
  • Medical Oncology, All India Institute of Medical Sciences, 110029 - New Delhi/IN

Abstract

Background

Taxane-based chemotherapy is used for the treatment of breast cancer in the neoadjuvant, adjuvant and metastatic setting. Docetaxel is known to increase overall survival and progression-free survival as a well as event-free survival. The majority of toxicities associated with docetaxel are myelosuppression, febrile neutropenia, mucositis, nail changes, and cutaneous depigmentation.

Methods

We retrospectively analysed clinicopathological information on all docetaxel-treated patients with breast cancer at our centre from 1st January to 31th December 2015. 592 of these received treatment at our centre and had adequate clinical details and follow up. Grades of toxicity were assessed before each cycle of chemotherapy using common toxicity criteria for adverse events (CTCAE)v 4.0 criteria.

Results

Of 592 patients whose data were reviewed, 49 (8.2%) of all evaluable patients had some grades of docetaxel toxicity. The overall toxicity profile and grades are detailed in the table. The median age at presentation was 45 years (range 30-61). Most of our patients received docetaxel as a part of adjuvant treatment (90%). The chemotherapy regimen associated with docetaxel toxicity is 4FEC-4D (5fluorouracil, epirubicin, cyclophosphamide, docetaxel). The median duration for cutaneous toxicity is the 4th cycle of docetaxel. Factors significant of any grades of toxicity are hypoalbuminemia, combination chemotherapy, and age>60 year.rn

Table: 533P Overall incidence of docetaxel toxicity

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
Toxicity typeAny Grade of Toxicity CTCAEv4.02Median number of cycleComments
MucositisI 13(2.1%) II 8(1.3%) III 11(1.8%) IV 2(0.3%)1(1-6)Grade 3 or 4 toxicity: 2.1% More with combination chemotherapy p = 0.035
Nail changesI 15(2.5%) II 2(0.3%)4(1-6)
Skin hyperpigmentationI 20(3.3%)4(1-6)
Skin ulcerII 3(0.5%)4(1-6)
rn

Conclusions

Docetaxel is an integral part of adjuvant, neoadjuvant as well as palliative chemotherapy in breast cancer patients. The FNCLCC PACS 01 trial using a FEC-D combination resulted in grade 3-4 stomatitis 4%, moderate or severe oedema 4.8%, moderate or severe nail disorder 10.3%. Though we used lower doses of docetaxel (85 mg/m2), the toxicity incidence was similar to that of the standard docetaxel dose used in the other trials. Age>60 years, use of combination chemotherapy, and hypoalbuminemia predisposes patients to increased incidence of docetaxel toxicity.

Clinical trial indentification

None

Legal entity responsible for the study

All India Institute of Medical Science, New Delhi

Funding

All India Institute of Medical Science, New Delhi

Disclosure

All authors have declared no conflicts of interest.