Relationship Between Anthracycline-cyclophosphamide Regimens and Docetaxel Monotherapy in Oral Mucositis Development

We have previously reported that patients experiencing oral mucositis (OM) during anthracycline-cyclophosphamide treatment develop symptoms following subsequent docetaxel-containing chemotherapy for perioperative breast cancer therapy. However, the concomitant use of pertuzumab and trastuzumab with docetaxel has also been suggested as a significant risk factor for OM. This study aimed to further evaluate the direct relationship of OM with anthracycline-cyclophosphamide treatment and docetaxel monotherapy.

Patients with breast cancer who underwent anthracycline-cyclophosphamide treatment followed by docetaxel monotherapy as perioperative therapy (n=63) were divided into control and OM-experience groups based on the absence or presence of OM development during prior anthracycline-cyclophosphamide treatment, and retrospectively evaluated. The primary endpoint was the comparison of all-grade OM incidence in the first docetaxel cycle between the two groups. The incidence of OM and dysgeusia was also assessed across all treatment cycles.

The incidence of all-grade OM was 42.9% in the OM-experience group and 9.5% in the control group during the first cycle (p=0.006) and 47.6% and 11.9% across all treatment cycles (p=0.004), thereby achieving the primary endpoint. In contrast, the incidence of grade ≥2 OM in both settings was higher in the OM-experience group than in the control group, although the difference was not statistically significant (14.3% vs. 2.4%, p=0.10 for both settings). Moreover, the incidence of dysgeusia did not differ between the two groups.

Patients exhibiting OM during prior anthracycline-cyclophosphamide treatment were significantly more likely to develop symptoms during subsequent docetaxel monotherapy for perioperative breast cancer therapy.