Chemo Choice May Minimize Toxicity Disparities for Black Patients With Breast Cancer
Among the taxanes currently approved for breast cancer treatment, docetaxel is the preferred agent for Black patients with breast cancer, researchers concluded in study findings presented (https://meetings.asco.org/2024-asco-annual-meeting/15810?presentation=232433#232433) at the 2024 American Society of Clinical Oncology Annual Meeting. In a study that only enrolled Black patients with breast cancer, the researchers found that docetaxel was associated with the lowest risk for taxane-induced peripheral neuropathy (TIPN), a dose-limiting adverse event that typically occurs more frequently in Black individuals.
For their prospective trial, researchers enrolled 249 patients who self-identified as Black and were receiving either weekly paclitaxel (n = 121) or every-three-week docetaxel (n = 118), as determined by their physician. They compared rates of physician-reported grade 2–4 TIPN and patient-reported TIPN for each treatment arm.
The researchers found that grade 2–4 TIPN was significantly higher in patients receiving paclitaxel than those receiving docetaxel in both physician reports (44% versus 29%) and patient reports (40% versus 24%). Additionally, patients receiving paclitaxel required more TIPN-related dose reductions (28% versus 9%) or any-cause dose reductions (39% versus 25%) compared to patients receiving docetaxel.
Previous studies have demonstrated that grade 2–4 TIPN occurs nearly twice as often (https://doi.org/10.1158%2F1078-0432.CCR-15-0586) in Black patients than all other races combined. “Given the disparate burden of TIPN and its potential impact on cure rates, this trial suggests docetaxel should be considered the preferred taxane for Black women with early-stage breast cancer,” the researchers concluded.
Learn more about taxanes and other plant alkaloids on the Oncology Nursing Podcast™ Episode 299: Pharmacology 101: Plant Alkaloids (https://www.ons.org/podcasts/episode-299-pharmacology-101-plant-alkaloids). Listen on your favorite podcast platform or use the player below.