Many women undergoing breast cancer treatment with taxanes, a type of cytostatic drug, commonly face nervous system side effects. A new tool has been developed by researchers to predict the risk level for each individual. This tool could assist doctors in adjusting treatment plans to help prevent lingering side effects in those at higher risk.
Many women undergoing breast cancer treatment with taxanes, a type of cytostatic drug, commonly face nervous system side effects. Researchers at Linköping University have created a predictive tool to assess individual risk levels. This tool could help doctors tailor treatments to reduce persistent side effects in those at greater risk.
An increasing number of people are surviving cancer. However, even after surviving the disease, many individuals continue to experience side effects from cancer treatment. In a recent study at Linköping University, the researchers examined the side effects of taxanes, a chemotherapy drug used to prevent breast cancer recurrence. A drawback of this treatment is that some patients may suffer nerve damage as a side effect.
“Nerve damage side effects are quite common following taxane treatment for breast cancer, and they can persist for several years. For those affected, it is highly stressful and significantly impacts their quality of life. This is a major clinical challenge that has garnered more attention in recent years, yet identifying individuals at higher risk for side effects has been a challenge,” says Kristina Engvall, who recently completed her PhD at Linköping University and works as a doctor at the oncology clinic at Ryhov County Hospital in Jönköping.
The researchers initially surveyed patients who had undergone breast cancer treatment with either docetaxel or paclitaxel, the two most common taxane drugs. The patients were between two and six years post-treatment. 337 patients were interviewed to report on the severity of nerve damage they experienced, also known as peripheral neuropathy. The most frequent issue reported was foot cramps, affecting more than a quarter of the patients. Other side effects included difficulty opening jars, foot numbness, foot tingling, and challenges climbing stairs.
The researchers analyzed the patients’ genetic sequences and developed models correlating genetic traits to different taxane treatment side effects. These models can predict the risk of nerve damage. Such predictive models, specifically for taxane-induced peripheral neuropathy, had not existed before. The researchers successfully predicted the risk of persistent foot numbness and tingling.
Using machine learning, the researchers divided the patients into two distinct groups: one at high risk for persistent side effects and another group corresponding to the frequency of peripheral neuropathy in the general population. They used two-thirds of the data to train the models and effectively validated them with the remaining one-third of patients. Ensuring the models work across different patient groups is a crucial validation step.
“This is the first instance of developing a predictive model for assessing nerve damage risk from taxane treatment. Women treated with taxanes post breast cancer surgery form a significant portion of the healthcare population globally, making this a major and clinically relevant issue,” says Henrik Gréen, a professor at Linköping University leading the study published in the journal npj precision oncology.
“This tool can help customize treatment, considering not just the benefits but also the risks each patient faces. Nowadays, breast cancer treatments are highly effective, prompting a need to focus more on potential complications and enduring side effects that impact patients long after treatment,” mentions Kristina Engvall.
In the future, the predictive model could become a standard tool in healthcare. However, further research is necessary to confirm its efficacy in populations beyond Sweden.
“We also discovered that three of the five symptoms we studied are so biologically intricate that we couldn’t model them. For instance, difficulty opening cans. This action involves both motor and sensory nerves, making it challenging to predict who is at higher risk of developing that symptom,” adds Henrik Gréen.
The study received funding from various organizations, including the Swedish Cancer Society, ALF funding, the Medical Research Council of Southeast Sweden (FORSS), and Futurum in Region Jönköping.
