Scholarlink

Purpose <p>Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect in patients treated with gemcitabine (GEM) and nanoparticle albumin-bound paclitaxel (nab-PTX) for pancreatic cancer, negatively impacting their quality of life. This study aimed to identify risk factors for significant CIPN development in a real-world setting of GEM + nab-PTX treatment to inform effective management strategies.</p> Methods <p>Patients with unresectable pancreatic cancer who received GEM + nab-PTX (n = 140) were retrospectively assessed. The primary endpoint was to identify the risk factor(s) associated with the development of problematic grade ≥ 2 CIPN within six months of treatment initiation. We also evaluated factors associated with all-grade CIPN and compared CIPN incidence across specific patient groups.</p> Results <p>The incidence of grade ≥ 2 CIPN was 35.0%, with 63.6% of patients experiencing symptoms of any grade. Multivariate Cox proportional hazard regression analysis identified baseline preexisting neuropathy as an independent risk factor for developing grade ≥ 2 CIPN (adjusted hazard ratio 4.03, 95% confidence interval 1.82–8.96, <i>P</i> = 0.0006). Conversely, dose modification of nab-PTX at or within 4&#xa0;weeks of treatment initiation emerged as a protective factor (0.45, 0.22–0.91, <i>P</i> = 0.03). Additionally, the cumulative incidence of grade ≥ 2 CIPN was significantly lower and delayed in patients who underwent dose modification within 4&#xa0;weeks compared to those who did not in the population with preexisting neuropathy (<i>P</i> = 0.01).</p> Conclusion <p>Baseline preexisting neuropathy significantly increases the risk, while early dose modification of nab-PTX serves as a protective factor against developing grade ≥ 2 CIPN in patients receiving GEM + nab-PTX treatment for pancreatic cancer.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Identification of risk factors related to problematic peripheral neuropathy development in gemcitabine and nab-paclitaxel treatment for pancreatic cancer

  • 期刊论文

  • 发表日期：

    2025年3月10日

查看全文
  • Yoshitaka Saito,
  • Yoh Takekuma,
  • Yoshito Komatsu,
  • Mitsuru Sugawara

摘要

Purpose

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect in patients treated with gemcitabine (GEM) and nanoparticle albumin-bound paclitaxel (nab-PTX) for pancreatic cancer, negatively impacting their quality of life. This study aimed to identify risk factors for significant CIPN development in a real-world setting of GEM + nab-PTX treatment to inform effective management strategies.

Methods

Patients with unresectable pancreatic cancer who received GEM + nab-PTX (n = 140) were retrospectively assessed. The primary endpoint was to identify the risk factor(s) associated with the development of problematic grade ≥ 2 CIPN within six months of treatment initiation. We also evaluated factors associated with all-grade CIPN and compared CIPN incidence across specific patient groups.

Results

The incidence of grade ≥ 2 CIPN was 35.0%, with 63.6% of patients experiencing symptoms of any grade. Multivariate Cox proportional hazard regression analysis identified baseline preexisting neuropathy as an independent risk factor for developing grade ≥ 2 CIPN (adjusted hazard ratio 4.03, 95% confidence interval 1.82–8.96, P = 0.0006). Conversely, dose modification of nab-PTX at or within 4 weeks of treatment initiation emerged as a protective factor (0.45, 0.22–0.91, P = 0.03). Additionally, the cumulative incidence of grade ≥ 2 CIPN was significantly lower and delayed in patients who underwent dose modification within 4 weeks compared to those who did not in the population with preexisting neuropathy (P = 0.01).

Conclusion

Baseline preexisting neuropathy significantly increases the risk, while early dose modification of nab-PTX serves as a protective factor against developing grade ≥ 2 CIPN in patients receiving GEM + nab-PTX treatment for pancreatic cancer.