Abstract P3-15-05: Muscle and Joint Symptoms in Breast Cancer Patients Receiving Taxane-Based Chemotherapy
Authors: van Draanen J , Stacey E , Dent R , Gallo-Hershberg D , Pasetka M , Giotis A , Kan K , van Draanen L , Fang T , Lee V , Walker S , DeAngelis C. 
Published: April 2011

Background: Docetaxel, paclitaxel, and (nab)-paclitaxel are taxanes used in treating breast cancer at various stages. While fairly well tolerated, they can cause distressing side effects. Both the prevalence and severity of muscle and joint symptoms (M&JS) in patients receiving taxane-based chemotherapies are poorly documented. We prospectively investigated the prevalence and severity of M&JS in women receiving taxane chemotherapy for breast cancer.

Methods: A total of 275 taxane-naive patients were enrolled in the study. This analysis presents data for 95 patients. For three consecutive treatmentcycles patients completed a baseline questionnaire as well as a diary, days 1 through 7 and on days 14 and 21 following treatment. Patient interviews were done by telephone days 2 to 3, and days 5 to 7 following treatment. They were then contacted at approximately three month intervals for one year. Data collection and data entry are ongoing; long term follow-up will conclude in August 2010.

Results: The average age of patients was 53 years. Disease status was classified as early for 50%, locally advanced for 35.34 %, and metastatic for 15.51% of patients. Overall 41.4% and 39.6% of patients reported muscle and joint pain, respectively, in their diaries on days 1 to 7. Muscle pain was most commonly reported in the legs, back, and arms and joint pain in the knees, ankles, and hips. The pain was most often described as aching, tiring, nagging, exhausting, and tender. The following scores are derived from a 10 cm visual analog scale. Of those who experienced pain in the seven days after treatment, the mean rating for pain at its worst was 5.15 and 5.02 for muscle and joint pain, respectively. Pain at its least had an average rating of 3.42 and 3.41 for muscle and joint pain, respectively. With respect to interference, patients who experienced pain had a mean score of 5.39, 4.86, 5.5, 4.12, 5.36, and 5.44 for interference with basic activities in daily life, mood, working or housework, relationships, sleeping and enjoyment of life, respectively. One, 3, 6, 9 and 12 months after taxane treatment ended, 27.2% (22/81), 31% (13/42), 45.5% (20/44), 37.2% (16/43), and 26.9% (7/26) reported muscle pain, respectively. Joint pain was reported by 26% (21/81), 38.1% (16/42), 43.2% (19/44), 48.8% (21/43) and 34.6% (9/26) of patients 1, 3, 6, 9 and 12 months following treatment, respectively. Data entry and analysis is ongoing and the final analysis will report on pain in relation to the taxane used, steroid tapering, role of anti-hormonal therapy, and effect of menopause on incidence of M&JS.

Discussion: Our preliminary data analysis indicates incidence rates of M&JS higher than previously reported during taxane treatment, and persistence of symptoms in a large proportion of patients up to a year following therapy completion. High pain scores and considerable interference with many aspects of life were reported. This study confirms the significant burden of M&JS during taxane chemotherapy. Conclusions: M&JS during taxane treatment is a common occurrence, and is significantly debilitating to the women who experience it. More research should be done regarding preventative measures and treatment options.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-15-05.