Kanno Ryota, Saito Yoshitaka, Takekuma Yoh, Takahashi Masato, Oshino Tomohiro, Sugawara Mitsuru
Department of Pharmacy, Hokkaido University Hospital, Kita 14-Jo, Nishi 5-Chome, Kita-Ku, Sapporo, 060 - 8648, Japan.
Department of Clinical Pharmaceutics & Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, 4 - 1, Maeda 7-Jo 15-Chome, Teine-Ku, Sapporo, Hokkaido, 006 - 8585, Japan.
Support Care Cancer. 2025 Apr 7;33(5):360. doi: 10.1007/s00520-025-09427-4.
Peripheral neuropathy is one of the most problematic adverse effects of docetaxel. We previously reported that dexamethasone (DEX) prevents taxane-associated acute pain syndrome (T-APS) in a dose-dependent manner, which might be a partial manifestation of chemotherapy-induced peripheral neuropathy (CIPN), in breast cancer treatment. Therefore, this study examined the dose-dependent prophylactic efficacy of DEX against CIPN.
Female patients with breast cancer receiving docetaxel-containing treatments (75 mg/m) were divided into two groups according to DEX dosage on days 2-4; an 8 mg group (n = 56) and a 4 mg group (n = 28) and retrospectively evaluated. The primary endpoint in this study was defined as the development of grade ≥ 2 CIPN during 4 cycles of the treatment.
The incidence of grade ≥ 2 CIPN was 32.1% in the 4 mg group and 10.7% in the 8 mg group and was significantly lower in the 8 mg group (P = 0.03). The incidence of all-grade CIPN was lower in the 8 mg group than in the control group, although the difference was not statistically significant (P = 0.06). Onset time of all-grade and grade ≥ 2 CIPN in the 8 mg group was significantly delayed compared to that in the 4 mg group (P = 0.003 and 0.01, respectively). Additionally, 8 mg/day of DEX was identified as a preventive factor for all-grade CIPN, although the evaluation of grade ≥ 2 symptoms was not possible.
Our study found that DEX attenuated docetaxel-induced CIPN in a dose-dependent manner during real-world breast cancer treatment. Further studies are needed to develop better CIPN management strategies.
周围神经病变是多西他赛最棘手的不良反应之一。我们之前报道过，地塞米松（DEX）在乳腺癌治疗中以剂量依赖的方式预防紫杉烷相关急性疼痛综合征（T-APS），这可能是化疗引起的周围神经病变（CIPN）的部分表现。因此，本研究探讨了DEX对CIPN的剂量依赖性预防效果。
接受含多西他赛治疗（75mg/m）的乳腺癌女性患者根据第2 - 4天的DEX剂量分为两组；8mg组（n = 56）和4mg组（n = 28），并进行回顾性评估。本研究的主要终点定义为治疗4个周期期间≥2级CIPN的发生。
4mg组≥2级CIPN的发生率为32.1%，8mg组为10.7%，8mg组显著更低（P = 0.03）。8mg组所有级别的CIPN发生率低于对照组，尽管差异无统计学意义（P = 0.06）。与4mg组相比，8mg组所有级别和≥2级CIPN的发病时间显著延迟（分别为P = 0.003和0.01）。此外，尽管无法评估≥2级症状，但8mg/天的DEX被确定为所有级别CIPN的预防因素。
我们的研究发现，在真实世界的乳腺癌治疗中，DEX以剂量依赖的方式减轻了多西他赛引起的CIPN。需要进一步研究以制定更好的CIPN管理策略。
