Breast Cancer: Targets and Therapy (Jan 2017)
Docetaxel-associated myalgia–arthralgia syndrome in patients with breast cancer
Abstract
Chelsea Seguin,1 Natalie Kovacevich,1 Ioannis A Voutsadakis,2,3 1Clinical Trials Unit, 2Division of Medical Oncology, Department of Internal Medicine, Sault Area Hospital, Sault Ste. Marie, 3Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON, Canada Background: As taxanes are increasingly used in oncology, the myalgia–arthralgia syndrome (M-AS) that represents an adverse effect of these drugs is becoming more common. Nevertheless, information regarding predisposing factors, prevention, and therapy of the syndrome is still lacking. Patients and methods: Women who had received docetaxel as part of the FEC-D(T) regimen for the adjuvant treatment of breast cancer were retrospectively identified from the records of our oncology department. Data on demographics, disease specifics, adverse effects, and treatment were reviewed. Patients were divided into two groups: those who developed M-AS after docetaxel treatment and those who did not develop the syndrome. The two groups were compared to identify risk factors for M-AS. Effectiveness of drugs used for M-AS was evaluated. Results: Sixty-seven patients were identified as fulfilling the inclusion criteria. Nineteen patients developed the M-AS after the first docetaxel administration. Forty-eight patients did not develop the syndrome. Three patients in this group were excluded because they had been taking gabapentin or pregabalin at the time of docetaxel administration for another indication. The remaining 45 patients constituted the control group. The two groups were similar in age, menopause status, stage of their cancer, and histology. The M-AS group had a higher median body surface area and was more likely to receive less than the three intended cycles of docetaxel. Nonsteroidal anti-inflammatory drugs, atypical antiepileptics, extended corticosteroids, and opioids were drugs used as M-AS treatments. Conclusion: Docetaxel-associated M-AS is an adverse effect causing incomplete drug treatment. Possible risk factors and effectiveness of treatments for the syndrome are presented. Keywords: myalgia–arthralgia syndrome, taxanes, gabapentin, pregabalin, adverse effects
