Fit for Chemo: Nerves May Thank You
Menée à partir de données portant sur 1 237 patientes atteintes d'un cancer invasif du sein, cette étude de cohorte prospective évalue l'association entre l'indice de masse corporelle, des facteurs liés au mode de vie (activité physique, consommation de fruits et de légumes) et le risque de neuropathie périphérique induite par une chimiothérapie à base de taxanes
Chemotherapy-induced peripheral neuropathy (CIPN) is a substantial treatment-related adverse event that can significantly impact cancer survivors’ life quality. Among breast cancer patients, it is a frequent dose-limiting toxicity that can lead to less taxane administration, which may affect cancer-related outcomes (1). Much remains to be understood regarding predisposing risk factors, mechanisms, and preventive and management interventions for CIPN.
In this issue of the Journal, Greenlee and colleagues report that body mass index (BMI), physical activity, and changes in antioxidant use were strongly associated with CIPN among women with breast cancer who received taxane-based chemotherapy (2). Using data from 1237 women who participated in the Pathways Study (3) to analyze the impact of several lifestyle factors on the development of CIPN, the authors found that CIPN was more prominent in patients who were overweight/obese and in those who started or discontinued antioxidant use during their chemotherapy time; in contrast, CIPN was less prominent in those who engaged in more than five hours per week of moderate-to-vigorous physical activity.
The relationship between higher weight and the development of CIPN among taxane recipients is supported by other studies. In an analysis of 4554 patients participating in the E1199 trial, Schneider et al. found a nonstatistically significant trend for higher risk of CIPN in obese compared with nonobese patients (odds ratio [OR] = 1.14, 95% confidence interval [CI] = 0.98 to 1.35, P = .095) (4). Subsequently, in an analysis of both ECOG-5103 and ECOG-1199, increased body surface area (BSA) was significantly associated with an increased risk (...)
Journal of the National Cancer Institute , éditorial, 2017