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Comparative Study
. 2025 Apr:80:104424.
doi: 10.1016/j.breast.2025.104424. Epub 2025 Feb 16.

Chronic chemotherapy-induced peripheral neuropathy and pain following paclitaxel versus docetaxel in breast cancer survivors: A cross-sectional study

Nina Lykkegaard Gehr  1 , Signe Timm  2 , Kristine Bennedsgaard  3 , Kasper Grosen  4 , Erik Jakobsen  5 , Anders Bonde Jensen  3 , Jeanette Dupont Rønlev  6 , Ann Søegaard Knoop  7 , Nanna B Finnerup  4 , Lise Ventzel  2
Affiliations
Comparative Study

Chronic chemotherapy-induced peripheral neuropathy and pain following paclitaxel versus docetaxel in breast cancer survivors: A cross-sectional study

Nina Lykkegaard Gehr et al. Breast. 2025 Apr.

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a concerning late effect of taxane treatment. This study aimed to explore and compare long-term symptoms and consequences of CIPN after docetaxel and paclitaxel treatment. Patients with breast cancer who had followed Danish recommended adjuvant docetaxel or paclitaxel treatment regimens completed an online questionnaire 2-3 years after treatment. The questionnaire comprised the Michigan Neuropathy Screen Instrument, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CIPN20, EORTC QLQ C30, and CIPN-specific symptoms. Painful CIPN was assessed using the Douleur Neuropathique 4 Questions. Questionnaires from 411 patients (docetaxel: 192, paclitaxel: 219) were analyzed. No significant difference in the prevalence of possible CIPN between the two groups was observed (docetaxel: 48.4 % [93/192] vs. paclitaxel: 45.2 % [99/219]; 95 % CI: 6.4 - 12.9, p = 0.51). However, the EORTC-QLQ-CIPN20 sum score was higher in the docetaxel group (difference: 3.0; 95 % CI: 0.0-6.1, p = 0.05). Among patients with reported CIPN symptoms, significantly more in the docetaxel group reported painful CIPN (docetaxel: 53.8 % [50/93] than in the paclitaxel group: 34.3 % [34/99]; p = 0.01). Quality of life scores from the EORCT-QLQ-C30 questionnaire were significantly lower in those with possible CIPN than in those without and lower in patients with painful possible CIPN than in those with painless CIPN. Docetaxel caused more severe and painful CIPN symptoms than paclitaxel. These findings are highly relevant, as docetaxel remains a crucial component of cancer treatments.

Keywords: Breast cancer; Chemotherapy-induced peripheral neuropathy; Neuropathic pain; Quality of life; Taxanes.

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Conflict of interest statement

Conflict of interests NBF has received consultancy fees from PharmNovo, Vertex, NeuroPN, Saniona, Nanobiotix, and Neurvati and has undertaken consultancy work for Aarhus University, including remunerated work for AKIGAI, Biogen, Merz, and Confo Therapeutics, all unrelated to the submitted work. She has received grants from IMI2PainCare, an EU IMI 2 (Innovative medicines initiative) public-private consortium, and the companies involved are Grunenthal, Bayer, Eli Lilly, Esteve, and Teva, all unrelated to the submitted work.

Figures

Fig. 1
Fig. 1
Flow chart.
Fig. 2
Fig. 2
Bar chart of EORTC QLQ-CIPN20 questionnaire responses from patients in the docetaxel and the paclitaxel group distributed on scores 2–4. Score 2: “A little”, Score 3: “Quite a bit,” Score 4:” Very much.” ∗p < 0.05 (Question 19: n = 337 – only answered if the patient drives a car).
Fig. 3
Fig. 3
Frequency of pain and moderate pain within the group of patients who reported symptoms defined as possible CIPN. ∗p < 0.05.
See this image and copyright information in PMC

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