Discussion
breast cancer, CIPN, prediabetes, anemia, taxane-related CIPN, diabetes
RECURRENCE, SIDE EFFECT, BREAST CANCER, DISEASE, PREDIABETES, PATHOPHYSIOLOGY, ANEMIA, DIABETES
In this study, we retrospectively identified possible characteristics associated with CIPN development during weekly paclitaxel chemotherapy treatment. We found that increased BMI was associated with a higher incidence of CIPN and that no other baseline characteristics were associated with CIPN severity. We also found a trend that higher chemotherapy dose intensity is associated with improved breast cancer free survival.Taxanes are cornerstones of chemotherapy regimens for all stages of breast cancer. However, taxane-related CIPN remains a highly prevalent side effect that can jeopardize the optimal delivery of chemotherapy. Currently there is no effective strategy to prevent CIPN development during chemotherapy.The pathophysiology of this connection is not fully understood, but it is likely multifactorial. There is a suspected underdiagnosed prevalence of diabetes or prediabetes in the overweight population which in and of itself can influence nerve conduction.Those of African American race has a higher risk of CIPN and poor breast cancer outcomes.Baseline anemia was previously found to be correlated with CIPN severity, though in our cohort, there was no association between hemoglobin level and CIPN.Another major finding of our study was the association between weekly paclitaxel chemotherapy dose intensity and disease recurrence, as higher chemotherapy RDI was associated with improved disease-free survival (OR 1.025; 95% CI, 1.00-1.05; Some weaknesses of our study include a small cohort size, and that it included all women with early-stage breast cancer and overall mild to moderate CIPN. All baseline laboratory values were inconsistent due to the nature of a retrospective analysis, in particular, baseline thyroid function tests, vitamin levels, and hemoglobin A1c. This limits our conclusions regarding thyroid function and diabetes status as risk factors for CIPN status.