Study Suggests Docetaxel is Superior for Neuropathy in Black Patients With Breast Cancer

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Tarah Ballinger, MD, discusses findings from the phase 2 EAZ171 study of taxane-induced peripheral neuropathy in Black patients with breast cancer.

The phase 2 EAZ171 study investigated a chemotherapy side effect called taxane-induced peripheral neuropathy (TIPN) in Black women with early-stage breast cancer. Black women experience more TIPN than White women when receiving a specific treatment called weekly paclitaxel. This can lead to dose reductions and potentially worse outcomes. Interestingly, this difference isn't seen with another treatment, every-3-week docetaxel.

The researchers aimed to see if genetic factors could predict who would experience worse TIPN with paclitaxel. They also compared rates of TIPN and dose reductions between paclitaxel and docetaxel.

The study found that genetic factors did not significantly impact TIPN risk. However, docetaxel was clearly better tolerated with less severe TIPN and fewer dose reductions compared to paclitaxel. This suggests that docetaxel may be a better choice for Black women with early-stage breast cancer to reduce the burden of side effects and potentially improve treatment outcomes.

Here, Tarah Ballinger, MD, associate professor at Indiana University School of Medicine and Vera Bradley Foundation Scholar in Breast Cancer Research, discusses findings from the late-breaking abstract presented at the 2024 ASCO Annual Meeting.

Transcription:

0:05 | EAZ171 was a study specifically looking at taxane-induced peripheral neuropathy in black patients. Taxane-induced peripheral neuropathy limits quality of life but also our ability to deliver all of the doses that are planned. Black patients are not only more likely to have taxane-induced neuropathy, they're also more likely to need dose reductions which can complicate result in lower cure rate specifically for Black patients. We have also found that through the lab of Dr. Brian Schneider, who's one of my mentors, that there may be specific germline markers that can predict for which black patients are more likely to get neuropathy.

So EAZ171 was a prospective trial designed to try to validate those germline markers specifically in Black women with early stage breast cancer and also to determine if docetaxel or paclitaxel would be the preferred taxane specifically for Black women with early stage breast cancer.

0:59 | In EAZ171, we did find higher rates of taxane-induced peripheral neuropathy in black patients with a high-risk genotype but that did not meet statistical significance. But the study was important for Black women with breast cancer because we found significantly less neuropathy with docetaxel versus paclitaxel, and also significantly less dose reductions with docetaxel either due to neuropathy or due to any cause. And that suggests that maybe this should be the preferred taxing specifically for Black patients.

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