ASPO Abstracts
Prospective functional effects of paclitaxel treatment on breast cancer patients, a pilot study
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Introduction: Female cancer patients treated with chemotherapy demonstrate a higher
prevalence of falls compared to community dwelling older adults. We are characterizing
elements associated with falling, such as balance, strength, neuropathy, and body
composition among female breast cancer patients receiving weekly or biweekly paclitaxel
chemotherapy for 3-4 cycles (700-960mg/m2 total dose). These preliminary data
represent participants that have completed two cycles of paclitaxel treatment
(measurements at baseline, pre-cycle 2 and pre-cycle 3; N=7 evaluable of N =20 target
enrollment)
Methods: For this prospective observational analysis we have collected repeat measures
of the following: body mass index (BMI); body composition by bioelectrical impedance;
balance by timed single-leg stance test (SST); strength by hand-grip dynamometer;
neuropathy by clinical neuropathy grading (CTCAE) and neuropathy symptoms by FACT
GOG-Ntx questionnaire; and falls incidence by adapted Women’s Health Initiative falls
questionnaire.
Results: To date, the female breast cancer patients enrolled are 54.8 ± 12.9 years of age,
with a BMI of 29.7 ± 7.4kg/m2 and total body fat of 43.7 ± 10.0% at baseline. Over the
course of two cycles of paclitaxel treatment, BMI and body composition did not change.
Clinical assessment of CTCAE neuropathy grade increased significantly (0.6 ± 0.5;
p=0.03), with a trend toward an increase in self-reported neuropathy symptoms
(p=0.086). Balance and strength decreased non-significantly (-10.5 ± 15.0 seconds SST
and -1.5 ± 3.0 kg hand-grip strength, respectively). As expected, women with fewer self-
reported neuropathy symptoms had better balance on the SST after two cycles of
paclitaxel (r=0.78; p=0.04). No patients have fallen subsequent to paclitaxel treatment.
Conclusion: Risks factors for falls were increased within two cycles of paclitaxel therapy
among female breast cancer survivors, though many did not reach significance.
Increased sample, and completion of study measures among participants during the
remaining cycles of treatment, will determine if the early trends continue and if falls occur
prior to paclitaxel treatment completion.
Funding Sources: Disarm Therapeutics and the National Cancer Institute (CA023074,
CA143924, R25CA217725)
Keywords: falls, balance, physical function, neuropathy, cancer