Hemoglobin, Body Mass Index, and Age as Risk Factors for Paclitaxel- and Oxaliplatin-Induced Peripheral Neuropathy

Area of Science:

• Oncology
• Neuroscience
• Clinical Pharmacology

Background:

• Chemotherapy-induced peripheral neuropathy (CIPN) is a significant adverse effect of neurotoxic cancer treatments like taxanes and platinum agents.
• Limited understanding exists regarding pre-chemotherapy factors that may predict CIPN development.

Purpose of the Study:

• To investigate the association between pretreatment blood-based and clinical factors and the persistence of CIPN in patients receiving paclitaxel or oxaliplatin.
• To identify potential risk factors for developing CIPN before initiating chemotherapy.

Main Methods:

• A cohort study involving 333 patients treated with paclitaxel or oxaliplatin chemotherapy in Australia.
• Assessed pretreatment blood-based clinical factors and demographic characteristics.
• Comprehensive neuropathy assessments (neurological grading, nerve conduction studies, functional tests, patient-reported outcomes) were conducted 3-12 months post-treatment.

Main Results:

• Low pretreatment hemoglobin levels were significantly associated with worse post-treatment CIPN.
• Multivariable analysis revealed that lower hemoglobin, higher body mass index (BMI), older age, and female sex were independently associated with worse CIPN.
• Specifically, lower hemoglobin (β=-0.47), higher BMI (β=0.08), older age (β=0.08), and female sex (β=-1.08) were linked to increased CIPN severity.

Conclusions:

• Pretreatment factors including low hemoglobin, high BMI, older age, and female sex are associated with a higher likelihood of developing CIPN after paclitaxel or oxaliplatin.
• These findings suggest potential targets for risk stratification and intervention to mitigate CIPN development.