Masteronderzoek Interne Oncologie

MASTERONDERZOEK AFDELING INTERNE ONCOLOGIE

Title
Risk and risk factors of chemotherapy-induced peripheral neuropathy in breast cancer patients

Contact details
Dr. Maartje Hooning, Associated Professor Cancer Epidemiology
Dept. of Medical Oncology
Erasmus MC Cancer Institute
E-mail: m.hooning@erasmusmc.nl

Background
Approximately 30-40% of cancer patients experience some form of neuropathy during or after chemotherapy treatment. This so-called chemotherapy-induced peripheral neuropathy (CIPN) is one of the most challenging side effects of chemotherapy. Damage to the peripheral nerves may result in pain, numbness, tingling, weakness or balance problems. Hands and feet often are the most affected. The risk of CIPN depends on the type of chemotherapy and the cumulative dose given, increasing with each cycle of chemotherapy. In breast cancer treatment taxane-based chemotherapeutic regimens are known for causing CIPN (42% to 70%; grades 3/4: ≤7%) and about 25% of patients stop treatment prematurely.

Problem description
At present, there is very little insight into how often CIPN occurs in breast cancer patients treated with chemotherapy, what the distribution is by severity of the complaints and which patients are at higher risk for CIPN. It is assumed that taxanes in combination with platinum pose a different risk of CIPN than taxanes alone. For effective treatment of breast cancer it is of great importance to know the individual risk profile for CIPN in advance.

Solution/research direction

• To determine the incidence of CIPN in our hospital-based BC database, in particular how often persistent neuropathy occurs with the possible consequence of premature discontinuation of treatment.
• To identify risk factors for CIPN in order to better estimate at an individual level whether a patient has an increased risk of severe CIPN, so that we can consider the option for other therapy in time.

Purpose of the current study
To develop a risk profile for CIPN in order to adjust breast cancer treatment in time if necessary and prevent serious complaints from CIPN.

Type of research
For this retrospective cohort study you will:

• select female patients who are diagnosed with ER+/HER2- or triple negative breast cancer from our hospital-based breast cancer database;
• collect additional data on symptoms of CIPN from the institutional patient hospital files in Electronic Health Records (EHR);
• collect data on other potential risk factors for CIPN as reported in literature;
• compare the risk of CIPN between patients treated with taxanes plus platinum and patients treated with taxanes only, taking into account other risk factors;
• perform statistical analyses, and interpret the results;
• discuss the final results in an oral presentation, and write them down in a scientific report.

This project will be supervised by Dr. Agnes Jager, Medical oncologist, and Dr. Maartje Hooning, Cancer epidemiologist. Other people involved in this project: Dr. Joost Jongen Neuro-oncologist and Mandy van Rosmalen, Nurse specialist oncology