Moore Donald C, Ringley J Tanner, Nix David, Muslimani Ala'a
Atrium Health, Levine Cancer Institute, Concord, NC.
Atrium Health, Levine Cancer Institute, Charlotte, NC.
Clin Lymphoma Myeloma Leuk. 2020 Mar;20(3):168-173. doi: 10.1016/j.clml.2019.08.012. Epub 2019 Sep 18.
Peripheral neuropathy is one of the most common dose-limiting toxicities associated with bortezomib; it can lead to dose reductions or therapy discontinuation. Obesity has been identified as being a risk factor for the development of peripheral neuropathy with other neurotoxic anticancer agents. We aimed to evaluate the impact of obesity on the incidence and severity of bortezomib-induced peripheral neuropathy.
This is a retrospective, single-center study of patients treated with subcutaneous bortezomib between January 1, 2012 and June 1, 2017. Eligible patients received at least 1 full cycle of subcutaneous bortezomib and had previously untreated, newly diagnosed multiple myeloma. Patients who received intravenous bortezomib or concomitant thalidomide were excluded. Patients were divided into 3 groups based on their body mass index (BMI): normal/underweight (BMI < 25), overweight (BMI = 25-29.9), and obese (BMI ≥ 30).
A total of 143 patients fitting the inclusion criteria were identified. Patients across the 3 groups received bortezomib at similar doses and schedules (weekly vs. biweekly). Obese patients had an increased incidence in developing bortezomib-induced peripheral neuropathy (56.4%) compared with normal/underweight (17.3%) and overweight patients (26.9%). Further analysis showed that, compared with normal/underweight and overweight patients, obesity was not found to be associated with an increased risk of grade 3 to 4 bortezomib-induced peripheral neuropathy (P = .451).
Obese patients were found to be at higher risk for the development of bortezomib-induced peripheral neuropathy compared with non-obese patients.
周围神经病变是与硼替佐米相关的最常见剂量限制性毒性之一；它可导致剂量减少或治疗中断。肥胖已被确定为与其他神经毒性抗癌药物相关的周围神经病变发生的一个风险因素。我们旨在评估肥胖对硼替佐米诱导的周围神经病变的发生率和严重程度的影响。
这是一项对2012年1月1日至2017年6月1日期间接受皮下注射硼替佐米治疗的患者进行的回顾性单中心研究。符合条件的患者接受了至少1个完整周期的皮下注射硼替佐米，且此前未经治疗、新诊断为多发性骨髓瘤。接受静脉注射硼替佐米或同时使用沙利度胺的患者被排除。根据体重指数（BMI）将患者分为3组：正常/体重过轻（BMI < 25）、超重（BMI = 25 - 29.9）和肥胖（BMI ≥ 30）。
共确定了143例符合纳入标准的患者。3组患者接受硼替佐米的剂量和给药方案相似（每周一次与每两周一次）。与正常/体重过轻（17.3%）和超重患者（26.9%）相比，肥胖患者发生硼替佐米诱导的周围神经病变的发生率更高（56.4%）。进一步分析表明，与正常/体重过轻和超重患者相比，未发现肥胖与3至4级硼替佐米诱导的周围神经病变风险增加相关（P = 0.451）。
与非肥胖患者相比，肥胖患者发生硼替佐米诱导的周围神经病变的风险更高。
