Abstract P6-11-08: Chemotherapy-induced peripheral neuropathy and quality of life among breast cancer survivors
Authors: Zaleta AK , Miller MF , Johnson J , McManus S , Buzaglo JS 
Published: February 2018

Abstract
Introduction: Breast cancer survivors are at risk for long-term chemotherapy-induced peripheral neuropathy (PN), which has few treatment options and can affect quality of life. We examined 1) the presence and severity of PN and its correlates among 442 metastatic (MBC) and 238 breast cancer (BC) survivors who received chemotherapy, and 2) provider communication, preparation, and confidence in managing treatment side effects (SEs). Methods: MBC and BC survivors enrolled in the Cancer Support Community's Cancer Experience Registry reported history of chemotherapy-induced PN and how disruptive (0=not at all; 4=very much) PN was to daily life. Participants also reported cancer-related distress (CancerSupportSource®, a 25-item measure with a 4-item depression/anxiety risk subscale) and quality of life (QoL; PROMIS-29). We examined the association between PN history, PN disruption, distress, risk for depression/anxiety, and worse QoL (PROMIS subscales &gt;1SD from norms) with multivariate linear and logistic regression, adjusting for metastatic disease and number of comorbidities. We also explored associations between PN disruption, provider communication, preparation, and confidence in managing SEs. Results: Mean age was 55y (SD=10); 89% non-Hispanic White; 43% had ≥2 comorbidities. More MBC patients (66%) experienced PN than BC (54%; chi2=8.9, p&lt;.01). Severity of PN disruption did not differ by metastatic disease; 30% of all participants indicated PN was quite a bit or very disruptive to daily life. Experiencing PN was associated with greater distress (beta=6.6, p&lt;.001) and increased likelihood of risk for depression/anxiety (OR=1.77, 95% CI=1.26-2.48). The odds for worse sleep disturbance, pain interference, physical function, social role function, depression, fatigue, and anxiety were greater among those experiencing PN than not (n=266; ORs: 6.95-1.90 respectively; ps&lt;.05). After controlling for metastatic status and number of comorbidities in separate regression analyses, greater PN disruption was associated with greater distress and risk for depression/anxiety (semipartial rs=.12-.19, p&lt;.01) and poorer QoL (semipartial rs=.22-.34, ps&lt;.05), except for sleep disturbance where the relationship was not linear. Many survivors wished they received more help managing short-term SEs (39%) and long-term SEs (55%). Nearly one-third (32%) noted their provider had not suggested ways to cope with SEs and 33% were not confident in their ability to cope with SEs. Greater PN disruption was associated with wanting more help managing short-term SEs (n=121; p&lt;.05) and not being counseled on ways to cope with SEs by the health care team (p&lt;.05). Conclusion: Chemotherapy-induced peripheral neuropathy is associated with poorer functional outcomes and symptom burden among breast cancer survivors, whether or not their breast cancer has metastasized. Many survivors do not feel confident in coping with side effects and want more support in side effect management, yet a substantial proportion note their provider did not discuss coping strategies with them. Without effective pharmacologic intervention for PN, providers are encouraged to assess and refer survivors to appropriate supportive services, and PN should be considered as a meaningful endpoint in clinical studies.
Citation Format: Zaleta AK, Miller MF, Johnson J, McManus S, Buzaglo JS. Chemotherapy-induced peripheral neuropathy and quality of life among breast cancer survivors [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-11-08.