334MO - Haemoglobin, body mass index and age as risk-factors for paclitaxel- and oxaliplatin-induced peripheral neuropathy

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting and debilitating side-effect of neurotoxic cancer treatments including taxanes and platinum agents. Limited knowledge exists of potential pre-chemotherapy biomarkers which may be associated with the development of CIPN.

Methods

Comprehensive neuropathy assessments were undertaken cross-sectionally in patients 3-12 months post-paclitaxel or oxaliplatin. CIPN was objectively assessed using composite neurological grading scales, nerve conduction studies, clinical grading scale, patient-reported outcomes, fine-motor skills and sensory function. Post-treatment CIPN severity was compared with blood-based biomarkers within 30 days prior to commencing chemotherapy. Independent samples t-tests with post-hoc Bonferroni correction were used to compare CIPN between patients according to blood-based biomarker normative ranges, with significance adjusted to p<0.006. Linear regression was used to identify blood-based and clinical biomarker associations with CIPN development.

Results

333 participants were recruited (n=228 paclitaxel, n=105 oxaliplatin; 80% female, mean age=57.6±12.3 years). The majority of participants had ≥grade 1 CIPN (73%). Participants with low haemoglobin pre-treatment had worse CIPN post-treatment (composite grading scale; p=0.002, grooved pegboard p=0.005, grating orientation task p=0.03, two-point discrimination p=0.012), with no other impairments outside blood-based normative ranges impacting CIPN. A multivariable model predicting worse CIPN was significant (F(4,326)=18.5, p<0.0001, r²=0.19) including lower haemoglobin (B=-0.04, 95% CI=-0.07--0.02, p=0.001), higher BMI (B=0.07, 95% CI=0.02-0.12, p=0.007), older age (B=0.08, 95% CI=0.06-0.11, p<0.001) and female sex (B=-0.96, 95% CI=-1.76--0.16, p=0.02).

Conclusions

Patients with low pre-treatment haemoglobin, higher BMI, and older age are more likely to develop paclitaxel- or oxaliplatin-induced CIPN post-treatment. Future research should investigate prospectively whether correcting haemoglobin and BMI mitigates CIPN development.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Cancer Institute NSW Program Grant (14/TPG/1-05) National Health and Medical Research Council of Australia (NHMRC) Project Grant (no. 1080521).

Disclosure

All authors have declared no conflicts of interest.