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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2020

01-04-2020 | Breast Cancer | Clinical trial

Vitamin D deficiency increases severity of paclitaxel-induced peripheral neuropathy

Authors: Theodore S. Jennaro, Fang Fang, Kelley M. Kidwell, Ellen M. Lavoie Smith, Kiran Vangipuram, Monika L. Burness, Jennifer J. Griggs, Catherine Van Poznak, Daniel F. Hayes, N. Lynn Henry, Daniel L. Hertz

Published in: Breast Cancer Research and Treatment | Issue 3/2020

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Abstract

Purpose

Approximately 25% of patients receiving weekly paclitaxel for breast cancer require treatment disruptions to avoid severe, irreversible peripheral neuropathy (PN). Vitamin insufficiencies are PN risk factors in many diseases, but their relevance to chemotherapy-induced PN is unknown.

Methods

We investigated whether baseline insufficiency of vitamin D, vitamin B12, folate, or homocysteine increased PN in patients with breast cancer receiving weekly paclitaxel in a retrospective analysis of a prospective observational study. Patient-reported PN was collected at baseline and during treatment on the Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy (CIPN20). The primary analysis tested associations between vitamin deficiency and the maximum increase from baseline in the CIPN20 sensory subscale (ΔCIPN8). Secondary analyses tested for association with PN-induced treatment disruptions and adjusted associations for treatment and clinical variables.

Results

25-hydroxy-vitamin D was the only nutrient with sufficient deficiency (< 20 ng/mL) for analysis (15/37 = 41%). Vitamin D-deficient patients had a greater mean PN increase than non-deficient patients (ΔCIPN8 ± SD, 36 ± 23 vs. 16 ± 16, p = 0.003) and a non-significant, approximately threefold increase in risk of treatment disruption (OR 2.98, 95% CI [0.72, 12.34], p = 0.16). In multivariable models adjusted for clinical and treatment variables, baseline vitamin D level was inversely associated with PN (β = − 0.04, p = 0.02).

Conclusion

Pre-treatment vitamin D deficiency was associated with PN in women receiving weekly paclitaxel for breast cancer. Vitamin D deficiency may be an easily detected PN risk factor that could be resolved prior to treatment to prevent PN, avoid treatment disruptions, and improve treatment outcomes.
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Metadata
Title
Vitamin D deficiency increases severity of paclitaxel-induced peripheral neuropathy
Authors
Theodore S. Jennaro
Fang Fang
Kelley M. Kidwell
Ellen M. Lavoie Smith
Kiran Vangipuram
Monika L. Burness
Jennifer J. Griggs
Catherine Van Poznak
Daniel F. Hayes
N. Lynn Henry
Daniel L. Hertz
Publication date
01-04-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05584-8

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