Specific Dosing Regiment May Reduce Chemo Side Effect
- Peripheral neuropathy (ie. tingling, numbness, pain, or weakness in the hands and feet) can be a really difficult side effect of chemotherapy.
- Peripheral neuropathy disproportionately affects Black women, often leading to more dose reductions and potentially impacting survival rates.
- A new study found that giving a specific drug, a type of taxane called docetaxel, every three weeks (rather than weekly paclitaxel) led to fewer symptoms in Black women with early-stage breast cancer.
Unfortunately, Black women with breast cancer have been found to experience more severe peripheral neuropathy compared to white women when receiving some forms of taxane therapy, leading to more treatment dose reductions and, in some cases, worse outcomes.
Read MoreDisparities in Cancer Care
Getting Black women access to better care is key to improving outcomes, and it’s an ongoing issue.
“The socioeconomic issue plays a role in breast cancer survival rates,” Dr. Anita Johnson, a breast surgical oncologist at City of Hope Atlanta, previously told SurvivorNet in a conversation about disparities in cancer care.
“Women who live in communities in which they don’t have access to oncologists, that sometimes can delay their care. Just having transportation to multiple physician visits is an issue, as well as patients who are underinsured … this is an emergency. It’s not new. It’s been going on for several decades.
Dr. Anita Johnson outlines the pathway to equal access to cancer care.
“When we’re looking at solutions, education is key, clinical trials is key, access to care is key,” she added.
Getting more diverse populations enrolled in clinical trials is an ongoing area of focus in cancer research.
What is Peripheral Neuropathy?
Peripheral neuropathy can range from mild, occasional numbness to severe, constant pain that affects balance or fine motor skills. In breast cancer treatment, this issue becomes especially serious if it leads to reduced doses or early discontinuation of life-saving chemotherapy. When patients cannot complete their prescribed treatment plan, the chance of cancer returning can rise. Past research has shown that Black women are more likely to experience this severe neuropathy, often leading to higher rates of dose reductions and potentially impacting survival.
Key Findings From the EAZ171 Trial
The EAZ171 trial was a phase 2 study designed to:
- Validate whether certain inherited (germline) genetic differences could predict who would develop peripheral neuropathy from taxanes.
- Compare the rates of peripheral neuropathy in Black women receiving either weekly paclitaxel or docetaxel every three weeks.
A total of 249 Black women with early-stage breast cancer took part, and researchers monitored them for nerve-related side effects, dosage changes, and how well they tolerated their assigned therapy. Some important results:
- Less Peripheral Neuropathy with Docetaxel: Women receiving docetaxel once every three weeks had significantly fewer cases of moderate-to-severe neuropathy than those receiving weekly paclitaxel.
- Fewer Dose Reductions: In the docetaxel group, only about 9% of patients had to reduce their dose due to neuropathy, compared to 28% in the weekly paclitaxel group.
- Genetic Markers Not Confirmed: Although doctors suspected that certain genes might predict neuropathy risk, the study did not conclusively confirm this. Most patients were genetically classified as “high risk,” but their actual rates of neuropathy varied, and the difference was not statistically significant.
These findings suggest that docetaxel given every three weeks may be an especially good option for Black women who need taxane-based chemotherapy, as it can help reduce the likelihood of peripheral neuropathy and enable them to stay on track with their treatment.
Why the Findings Matter for Black Patients
Black women in the United States face higher death rates from breast cancer compared to white women—about 40% higher, according to various reports—despite having, on average, slightly lower incidence rates of the disease.
Multiple reasons drive this disparity, including:
- More Aggressive Tumors: Black women are more likely to develop harder-to-treat types of breast cancer (like triple-negative) at younger ages.
- Differences in Access to Care: Barriers such as cost, insurance coverage, and quality of care can affect how soon women get diagnosed and how consistently they can continue treatment.
- Treatment Side Effects: Peripheral neuropathy and other toxicities may be more common or more severe, leading to dose reductions or early stoppage of therapy.
By identifying treatments that cause fewer nerve-related side effects, doctors can help Black women complete their full course of therapy, which is critical to improving overall outcomes and survival.
Coping with Peripheral Neuropathy
Even if you or your loved one is on a chemotherapy regimen that poses a lower risk of neuropathy, you could still face nerve-related side effects.
Here are some tips to help manage and cope:
- Speak Up Early: Tell your doctor or nurse about any numbness, tingling, or pain as soon as it begins. Early intervention can sometimes prevent symptoms from worsening.
- Protect Your Hands and Feet: Wear shoes and socks that fit well to avoid injury. Use warm (not hot) water to wash your hands or feet, and check your skin regularly for cuts or blisters.
- Ask About Medications or Supplements: Some supplements, pain relievers, and topical creams might help with nerve pain. Always consult your medical team before starting anything new.
- Physical and Occupational Therapy: Specialized exercises or assistive devices may reduce discomfort and help maintain balance, coordination, and the ability to perform daily tasks.
- Stay Active: Light exercise, like walking or low-impact yoga, can improve circulation and help with stiffness, though you should talk to your doctor first if you’re unsure about any activity.
- Seek Emotional Support: Dealing with breast cancer is already challenging, and adding peripheral neuropathy to the mix can be stressful. Consider professional counseling, support groups (in person or online), and leaning on family and friends for help.
Finding Hope and Looking Ahead
The EAZ171 trial is a powerful example of how researchers are listening to the voices of Black women and adapting studies to improve treatments, lower side effects, and ultimately save lives. Ongoing efforts across the country—like increasing access to state-of-the-art cancer care and ensuring insurance coverage—are also narrowing the gaps in breast cancer outcomes. Scientists are continually working on new ways to predict who is at risk for severe neuropathy, so that therapies can be personalized further.
If you are facing a breast cancer diagnosis or helping a loved one through treatment, remember that you do not have to walk this road alone. Ask your doctor about all available treatment options, including the possibility of once-every-three-weeks docetaxel if taxane-based chemotherapy is recommended. Seek community resources or patient advocacy groups that focus on supporting Black women’s needs. You deserve quality information, compassionate care, and a pathway to healing that minimizes the burdens of side effects.
Above all, know that there is hope. Advances in breast cancer research continue every day, and greater awareness of each woman’s unique biology and background is paving the way for more effective, less toxic treatment plans for Black women nationwide. If you have any questions or concerns, bring them to your health care team. They are there to support you every step of the way.
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