349P - The influence of diabetes on taxane-induced neurotoxicity and quality of life in breast cancer patients

Background

Peripheral neuropathy is one of the long-term complications of diabetes. In breast cancer diabetic patients, this condition can worsen neurotoxic symptoms induced by taxane-based therapy administration. Chemotherapy induced peripheral neuropathy (CIPN) and its influence on patient’s quality of life (QoL) is evaluated through certified questionnaires (NCI-CTC, EORTC QLQ-CIPN20, FACT-TAXANE).

Methods

Data from stage I-III breast cancer patients treated with taxane-based therapy between 2018 and 2022 were retrospectively analyzed at the Medical Oncology of the University Hospital of Cagliari. 300 patients, median age 57 years (32-85), followed a schedule of PCT 80mg/m2 ± 30 weekly per maximum 12 administrations; 43 patients had diabetes (14,3%). Peripheral neuropathy was evaluated by the NCI-CTC scale at every drug administration. QLQ-CIPN20 and FACT-TAXANE questionnaires were collected at baseline, at 4 and 12 weeks of treatment. Kruskal-Wallis test was used to assess relation between neurotoxicity grade and QoL; ANOVA for repeated measures was used to test differences at different timing. Student’s T-test was used to analyze differences in diabetic and non-diabetic population.

Results

Neurotoxicity influenced QoL, in both populations, at cycle IV (p<0.001) and cycle XII (p=0.008). Patients with grade 0, 1 and 2 neurotoxicity reported a QLQ-CIPN20 median score of 32, 34 and 43 at cycle IV respectively, and a median value of 27, 33 and 34 at cycle XII respectively. ANOVA test showed a significant worsening of QLQ-CIPN20 and FACT-TAXANE scores at 4 and 12 weeks vs. baseline (p<0.001 for both). Values of QLQ-CIPN20 remained significantly higher in comparison to baseline also at 3 (p<0.001), 6 (p<0.001) and 12 months (p<0.001) follow up. In diabetic population, scores were significantly higher (p<0.05) in all neurotoxicity questionnaires, but no difference in QoL was highlighted by FACT-TAXANE, compared to non diabetic patients.

Conclusions

The use of QLQ-CIPN20 and FACT-TAXANE questionnaires identified neurotoxicity onset and its correlation to QoL, yet at an initial phase of treatment. Diabetic patients presented more severe neurotoxicity, without influencing overall QoL.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.