Toxicity profile of weekly regimen of paclitaxel in patients with non-metastatic breast cancer-a real world experience (India)

Introduction: Taxanes especially paclitaxel is a key chemotherapeutic agent in the management of non-metastatic breast cancer. Different schedules are utilized in management with weekly paclitaxel being one of the common regimes. The weekly regimen has a distinctive toxicity profile. Methods: This retrospective study was done to study the adverse effect profile of weekly paclitaxel used in the treatment of non-metastatic breast cancer. Data were collected from case records of patients who received or were started on weekly paclitaxel single agent or in combination with trastuzumab between May and July 2019. Results: Eighty-eight patient case records were analyzed. The median age was 46.5 yrs (Range 30-67 yrs). The majority of patients received paclitaxel as an adjuvant (N=80, 91%). Sixty-one patients (69%) received single-agent paclitaxel while the remaining received it in combination with trastuzumab. Seventy-five percent (N=66) of patients did not have any modification of dosages in their regimen. Among those patients who required dose modification 19% (N=17) of patients required it from cycle 7 or beyond. Planned 12 cycles of weekly paclitaxel were completed in 81% (N=71) patients. The median duration for completion of 12 cycles from the start of chemotherapy was 80 days (Range 53-103). Major Grade 3/4 toxicities observed included peripheral neuropathy (12%) anemia (10%) and Neutropenia (4%). Conclusion: We observed a higher incidence of acute toxicities related to weekly paclitaxel though the majority of patients were able to complete their planned schedule of paclitaxel.