Abstract
Objectives: The main aims of this study is to describe the incidence and for both prevention and treatment of TAPS.
Methods: The Study was a prospective one in which we included Eligible patients scheduled to receive paclitaxel, nab paclitaxel or docetaxel either weekly or 3 weekly alone or combination with other chemotherapy. Patient-reported outcome for acute pain were collected and evaluated. Outcome measures of interest included the type of treatment for TAPS, as well as the response of myalgias, arthralgias, pain, and quality of life using Mc Gill Quality of life questionnaires. All those Patients who developed pain, were analyzed for response corticosteroid, gabapantine or duloxitine.
Results: A total of 80 patients were available for the analysis, of which 32 patients (40%) received paclitaxel and carboplatin, while as 30 patients (37.5%) received paclitaxel alone, 10 patients (12.5%) received nab paclitaxel and 8 patients (10%) received docetaxel. Among them 54 developed TAPS, comparing with corticosteroid, 30 Patients (55.5%) responded taxene induced pain by corticosteroid, 7 patients (12 percent) responded to gabapantin and 17 patients (31%) responded to duloxitine.
Conclusion: The present study has expanded the use of taxanes to numerous cancers. A larger number of patients are, at risk of taxane-induced pain syndrome. Possible strategies to decrease the incidence of pain syndrome include by addition of the medications, have been evaluated to reduce the incidence of TAPS. However, no therapy has been consistently successful; conventional analgesics are also inconclusive.
More studies should be performed to identify these characteristics as well as patients at risk for the development of taxane-induced myalgia and arthralgia, thereby allowing a risk-adapted strategy of medical prevention.
References
- Bissery M-C, Nohynek G, Sanderlink G-J, Lavelle F. 1995. Docetaxel (Taxotereâ): a review of preclinical and clinical experience. Part Preclinical experience. Anti- Cancer Drugs 6:339–55.
- Kearns CM, Gianni L, Egorin MJ. 1995.Paclitaxel pharmacokinetics and pharmacodynamics. Oncol. 22(Suppl. 6):16–23.
- Dumontet C, Jordan MA (2010) Microtubule-binding agents: a dynamic field of cancer therapeutics. Nat Rev Drug Discov 9: 790–80
- Rowinsky EK, Eisenhauer EA, Chaudhry V, Arbuck SG, Donehower RC. Clinical toxicities encountered with paclitaxel (Taxol). Semin Oncol. 1993;20:1–15.
- Garrison JA, McCune JS, Livingston RB, Linden HM, Gralow JR, Ellis GK, et al. Myalgias and arthralgias associated with paclitaxel. Oncology (Willisto Park). 2003;17:271–7. Discussion 281–272, 286–278.
- Reeves BN, Dakhil SR, Sloan JA, Wolf SL, Burger KN, Kamal A, et al. Further data supporting that paclitaxel-associated acute pain syndrome is associated with development of peripheral neuropathy: North Central Cancer Treatment Group trial N08C1 Cancer.2012;118:5171–8.
- Rowinsky EK, ChaudhryV, Cornblath DR, Donehower RC. 1993. The neurotoxicty oftaxol. Natl. Cancer Inst. 15:107– 15.
- Chaudhry V, Rowinsky EK, Sartorius SE, et al. 1994. Peripheral neuropathy from taxol and cisplatin combination chemotherapy: clinical and electrophysiological studies. Neurol. 35:490–97.
- Fujiwara H, Urabe T, Ueda K, et al: Prevention of arthralgia and myalgia from paclitaxel and carboplatin combination chemotherapy with Shakuyaku-kanzo-to [in Japanese]. Gan To Kagaku Ryoho 27:1061-1064, 2000.
- Martoni A, Zamagni C, Gheka A, et al: Antihistamines in the treatment of taxol-induced paroxystic pain syndrome. J Natl Cancer Inst 85:676, 1993.
- Markman M, Kennedy A, Webster K, et al: Use of low-dose oral prednisone to prevent paclitaxel-induced arthralgias and myalgias. Gynecol Oncol 72:100-101, 1999.
- Sarris AH, Younes A, McLaughlin P, et al: Cyclosporin A does not reverse clinical resistance to paclitaxel in patients with relapsed non-Hodgkin’s lymphoma. J Clin Oncol 14:233-239, 1996
- Jacobson SD, Loprinzi CL, Sloan JA, et al:Glutamine does not prevent paclitaxel-associated myalgias and arthralgias. J Support Oncol 1:274- 278, 2003.
- Markman M: Prevention of paclitaxel-associated arthralgias and myalgias. J Support Oncol 1: 233-234, 2003.
- Markman M, Kennedy A, Webster K, Kulp B, Peterson G and Belinson J: Use of low-dose oral prednisone to prevent paclitaxel-induced arthralgias and myalgias. Gynecol Oncol 72: 100-101, 1999.
- Nguyen V and Lawrence H: Use of gabapentin in the prevention of taxane-induced arthralgias and myalgias. J Clin Oncol 22: 1767-1769, 2004.
- Kajdasz DK, Iyengar S, Desaiah D, Backonja MM, Farrar KT, Fishbain DA, Jensen TS, Rowbotham MC, Sang CN, Ziegler D, McQuay HJ: Duloxetine for the management of diabetic peripheral neuropathic pain: evidence-based findings from post hoc analysis of three multicenter, randomized, double-blind, placebocontrolled, parallel-group studies. Clin Ther 2007, 29:2536-2546.
Corresponding Author
Dar Abdul Waheed