Factors affecting peripheral neuropathy induced by nanoparticle albumin‐bound paclitaxel in patients with pancreatic cancer

Author:

Kang Minseo1ORCID,Yoo Seunghyun1,Jung Yeolmae1,Lim Hayun1,Lee Myeong Hwan2,Ryu Ji Kon2ORCID,Lee Jangik I.1ORCID

Affiliation:

1. College of Pharmacy and Research Institute of Pharmaceutical Sciences Seoul National University Seoul Republic of Korea

2. Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital Seoul National University College of Medicine Seoul Republic of Korea

Abstract

AimChemotherapy‐induced peripheral neuropathy (CIPN) is a major toxicity limiting the use of nab‐paclitaxel (Nab‐P) in treating patients with pancreatic cancer. The aim of this study was to identify the factors affecting CIPN using patient‐reported outcome measures and the minimally invasive volumetric absorptive microsampling (VAMS) technique.MethodsThe maximum concentrations of paclitaxel (Cmax) were measured from 81 VAMS samples collected from 44 participants with pancreatic cancer. The association between CIPN development and demographic, clinical and pharmacokinetic factors was determined using univariable and multivariable logistic regression. The association between CIPN severity and the factors was evaluated using Spearman's rank correlation. The impact of Cmax and the number of treatment cycles on the severity was assessed using multivariable linear regression.ResultsThe development of CIPN was significantly associated with cumulative dose (odds ratio 1.005, 95% confidence interval [CI] 1.003‐1.007), treatment cycles (3.47, 2.25‐5.85), alkaline phosphate (0.992, 0.985‐0.998) and age (1.092, 1.020‐1.179), with an area under the receiver operating characteristic curve of 0.89 (95% CI 0.83‐0.95). The severity of CIPN significantly worsened with increasing cumulative dose (coefficient 0.58, 95% CI 0.44‐0.69), treatment cycles (0.57, 0.44‐0.68) and age (0.18, 0.00‐0.35). The severity of CIPN was predictable from treatment cycles (P = .0002) and Cmax (P = .01).ConclusionThe higher the cumulative dose of Nab‐P, treatment cycles and age, the more frequently and severely do the patients experience CIPN. In predicting the severity of CIPN using Cmax, minimally invasive VAMS is a feasible alternative to venous blood sampling.

Funder

National Research Foundation of Korea

Publisher

Wiley

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