Which women are at risk of nervous system damage after chemotherapy?

With a steadily declining mortality rate, more and more women are surviving breast cancer. However, some of them develop peripheral neuropathy several years after exposure to taxane-based chemotherapy. A new predictive tool could determine which women are most likely to suffer from these persistent side-effects even before starting treatment. According to one epidemiological study published in the British Journal of Cancer, within three years of completing chemotherapy, up to 48% of patients will experience symptoms related to sensory nerves (cramps and numbness in the feet) and up to 61% will experience symptoms related to motor nerves (difficulty climbing stairs or opening a jar). No medication is specifically designed to combat neuropathy. Since these side-effects can greatly affect quality of life, Swedish researchers have developed a predictive model based on genetics to target women at higher risk of nervous system damage.“Now that we can treat breast cancer better, we need to look at the risks of complications and side-effects that affect patients after treatment has ended,” said the authors of the study published in NPJ Precision Oncology. 25% of womenResearchers first monitored the onset of symptoms in 337 women, from two to six years after receiving docetaxel or paclitaxel to treat early breast cancer. They found difficulty opening a jar and cramps, numbness or tingling in the feet were among the most frequent symptoms, affecting more than 25% of women.Each woman was genetically sequenced using a blood sample. To build the predictive model, each symptom was associated with one or other of the 13 genetic variations linked to taxane-induced peripheral neuropathy. A meta-analysis identified these variants in 2022, reinforcing the genetic role in the predisposition of certain individuals to develop these side-effects. Depending on their genetic profile and clinical risk factors, each patient had a low or high risk of developing neuropathic lesions. The model used 70% of the cases for machine-learning training and 30% for model validation. The results were satisfactory for the prediction of two symptoms, tingling and numbness in the feet. “A high genetic susceptibility to persistent peripheral neuropathic injury could play a role in treatment selection based on risk-benefit assessment and patient preference,” said the researchers, colncluding it could also lead to increased monitoring during taxane therapy.

Which women are at risk of nervous system damage after chemotherapy?

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