Identification of risk factors related to problematic peripheral neuropathy development in gemcitabine and nab-paclitaxel treatment for pancreatic cancer

Saito, Yoshitaka; Takekuma, Yoh; Komatsu, Yoshito; Sugawara, Mitsuru

Identification of risk factors related to problematic peripheral neuropathy development in gemcitabine and nab-paclitaxel treatment for pancreatic cancer

Saito, Yoshitaka; Takekuma, Yoh; Komatsu, Yoshito et al.

Supportive care in cancer, 2025, 33(4)

Permalink : https://hdl.handle.net/2115/97513

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アクセス権	open access
URI	https://hdl.handle.net/2115/97513
タイトル	Identification of risk factors related to problematic peripheral neuropathy development in gemcitabine and nab-paclitaxel treatment for pancreatic cancer
著者	Saito, Yoshitaka ; Takekuma, Yoh ; Komatsu, Yoshito ; Sugawara, Mitsuru
e-Rad_Researcher 00835001 著者名 Saito, Yoshitaka
e-Rad_Researcher 00396293 著者名 Takekuma, Yoh
e-Rad_Researcher 60333598 著者名 Komatsu, Yoshito
e-Rad_Researcher 60332467 著者名 Sugawara, Mitsuru
言語	英語
キーワード	Gemcitabine
	Nab-paclitaxel
	Peripheral neuropathy
	Chemotherapy-induced peripheral neuropathy
	Risk factor
	Pancreatic cancer
発行日	2025-03-10
出版者	Springer
収録物名	Supportive care in cancer
巻(号)	33(4)
抄録	PurposeChemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect in patients treated with gemcitabine (GEM) and nanoparticle albumin-bound paclitaxel (nab-PTX) for pancreatic cancer, negatively impacting their quality of life. This study aimed to identify risk factors for significant CIPN development in a real-world setting of GEM + nab-PTX treatment to inform effective management strategies.MethodsPatients with unresectable pancreatic cancer who received GEM + nab-PTX (n = 140) were retrospectively assessed. The primary endpoint was to identify the risk factor(s) associated with the development of problematic grade >= 2 CIPN within six months of treatment initiation. We also evaluated factors associated with all-grade CIPN and compared CIPN incidence across specific patient groups.ResultsThe incidence of grade >= 2 CIPN was 35.0%, with 63.6% of patients experiencing symptoms of any grade. Multivariate Cox proportional hazard regression analysis identified baseline preexisting neuropathy as an independent risk factor for developing grade >= 2 CIPN (adjusted hazard ratio 4.03, 95% confidence interval 1.82-8.96, P = 0.0006). Conversely, dose modification of nab-PTX at or within 4 weeks of treatment initiation emerged as a protective factor (0.45, 0.22-0.91, P = 0.03). Additionally, the cumulative incidence of grade >= 2 CIPN was significantly lower and delayed in patients who underwent dose modification within 4 weeks compared to those who did not in the population with preexisting neuropathy (P = 0.01).ConclusionBaseline preexisting neuropathy significantly increases the risk, while early dose modification of nab-PTX serves as a protective factor against developing grade >= 2 CIPN in patients receiving GEM + nab-PTX treatment for pancreatic cancer.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s00520-025-09336-6
PISSN	0941-4355
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00520-025-09336-6