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).
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.
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).
|TC (n = 10)||FEC-D (n = 2)||Single agent Palcitaxel(N = 9)||AC-P or AC-D (n = 3)|
|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
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
Legal entity responsible for the study
Ottawa Hospital Regional Cancer Centre
Ottawa Hospital Regional Cancer Centre (Internal)
All authors have declared no conflicts of interest.