Analysis Of Related Factors Of Peripheral Neurotoxicity Induced By Nanoparticle Albumin Bound Paclitaxel Injection In Advanced Breast Cancer

Purpose:In order to observe the adverse reactions of advanced breast cancer patients using three different kinds of nab-Paclitaxel collected by the National Collection,and to explore the incidence and severity of peripheral neurotoxicity,we screened out the risk factors related to neurotoxicity,so as to provide reference for the prevention and treatment of neurotoxicity.Method:A total of 90 cases diagnosed as advanced breast cancer by using nab-Paclitaxel chemotherapy regimen for injection in the breast diagnosis and treatment center of a3 A hospital in Qingdao from January 2018 to December 2020 were collected and the clinical data were retrospectively analyzed.Basic information and clinical data of patients were collected,and the incidence and severity of adverse reactions in patients were collected.Baseline characteristics of patients were compared according to whether peripheral neurotoxicity occurred.The risk factors affecting the peripheral nerve development of nab-Paclitaxel for injection were explored through binary logistic regression analysis.Result:(1)We have summarized the adverse reactions of nab-Paclitaxel in patients,of which the organ systems involved mainly include blood system,nervous system,digestive system,respiratory system,neuromuscular and skeletal reactions,skin and mucosal reactions,etc.(2)Neurotoxicity occurred in 53 of 90 patients(59%),accounting for the highest proportion of adverse reactions other than blood toxicity.The main symptoms are manifested as numbness of peripheral nerves,which is mainly graded as I–II.Peripheral nerve toxicity mostly occurs three weeks before chemotherapy.(3)A univariate analysis was performed on age,BMI,BSA,pathological type,molecular type,ECOG physical status score,usage and dosage,chemotherapy regimen,number of metastatic sites,previous combined diseases,and different manufacturers.The results showed that age,pathological type,BSA,BMI,and molecular type P < 0.2were finally included in the multivariate analysis,but the incidence of neurotoxicity between different manufacturers and among different manufacturers was not statistically significant.(4)The binary logistic regression analysis showed that age and molecular type(P < 0.05)were the risk factors for neurotoxicity of nab-Paclitaxel.In the binary Logistic regression analysis of age,P=0.042,and the difference was statistically significant.For each additional year of age,the incidence of neurotoxicity in the ≥55group was 0.336-fold higher than that in the < 55 group.P=0.049 in the binary Logistic regression analysis of molecular typing,and the difference was statistically significant.The incidence of peripheral neurotoxicity was higher in Sanyin,Luminal A,and Luminal B(HER2-)patients compared with HER2+ patients,and there was no significant difference in Luminal B(HER2+)patients compared with HER2+ patients.Conclusion:During the use of nab-Paclitaxel in advanced breast cancer,a higher incidence of neurotoxicity was found in adverse reactions.In this study,the binary logistic regression analysis showed that age and molecular type were the risk factors for neurotoxicity of nab-Paclitaxel.For patients with high risk factors for neurotoxicity,from the perspective of clinical pharmacists,we should pay close attention to the occurrence of neurotoxicity in patients,and give active prevention and treatment measures when necessary.