Taxane Chemotherapy Linked to Neuropathy and Balance Issues in Older Breast Cancer Survivors

Taxane-based chemotherapy, a common treatment for breast cancer, is associated with an increased risk of neuropathy and balance problems in women aged 65 and older, according to research published in JCO Oncology Practice. However, the study found no link between taxane chemotherapy and an increased risk of falls.

Neuropathy and Balance Concerns

Researchers explained that balance issues can arise from decreased muscle strength and a loss of proprioception due to neuropathy. While long-term balance impairment in cancer survivors hasn’t been widely studied, these findings highlight the ongoing significance of neuropathy and balance problems for older breast cancer survivors, potentially impacting their quality of life and independence.

Study Methodology

The study utilized data from the Texas Cancer Registry-Medicare linked database, focusing on breast cancer survivors diagnosed between 2012 and 2013 who were 65 years or older and had localized or regional disease. A total of 4,448 survivors received questionnaires addressing demographics, health status, treatments received, fall outcomes, chemotherapy-related toxicities, and cognitive function.

The final analysis included 1,493 survivors who completed the questionnaires with complete data. The majority (over 80%) were non-Hispanic White, and 75.6% had localized disease. Approximately one-quarter (26.5%) of participants received chemotherapy, with taxanes being the most common type (89%). Docetaxel was the most frequently administered taxane (65%).

Key Findings

The study revealed that 25% of participants reported neuropathy, and 45.6% reported problems with balance or walking. Patients who underwent any type of chemotherapy were significantly more likely to report neuropathy within the past seven days compared to those who did not receive chemotherapy (61.8% vs 36.0%; P < .01). No statistically significant difference was observed regarding balance problems or the number of falls in the past 12 months based on chemotherapy receipt.

When comparing specific chemotherapy agents, patients treated with paclitaxel reported neuropathy more often than those treated with docetaxel (73.3% vs 55.7%; P < .01).

Multivariate analysis indicated that taxane-based chemotherapy was associated with higher odds of neuropathy (adjusted odds ratio (aOR), 3.0; 95% CI, 2.12-4.15) and balance problems (aOR, 1.60; 95% CI, 1.13-2.24) compared to no chemotherapy. However, taxane-based chemotherapy was not significantly linked to an increased risk of falls (aOR, 1.20; 95% CI, 0.83-1.64).

Implications for Patient Care

The researchers emphasize the need for ongoing assessments of balance and mobility in older breast cancer survivors who have received chemotherapy. Healthcare providers should proactively monitor patients for late chemotherapy effects, including neuropathy, as these can contribute to balance problems.

Disclosures: This research was supported by the Cancer Prevention and Research Institute of Texas (CPRIT), the Susan G. Komen Foundation, The Breast Cancer Research Foundation, and the National Cancer Institute. One study author disclosed conflicts of interest. Please see the original reference for complete disclosures.