Incidence of Antibody-drug Conjugate-induced Peripheral Neuropathy in Patients with Breast Cancer: A Systematic Review and Meta-analysis
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i3.4409
Abstract
Background: Although ADCs have revolutionized breast cancer treatment, their risk of peripheral neuropathy has not been systematically evaluated. Methods: We systematically reviewed articles and conference abstracts published up to May 10, 2024, from Web of Science, PubMed, and Cochrane Library databases. Data were extracted independently and analyzed using a random-effects model, with heterogeneity assessed by I2 statistics and p-values. Results: Our meta-analysis found the overall incidence of any-grade peripheral neuropathy in breast cancer patients treated with ADCs to be 17.99% (95% CI, 13.73–22.65%). The incidence was 12.95% (95% CI, 9.03–17.4%) for ADC monotherapy regimens, with trastuzumab deruxtecan (T-DXd) having the highest incidence at 18.17% (95% CI, 4.96–35.89%). Conclusions: ADC-associated peripheral neuropathy is common in breast cancer treatment. The highest rate of neuropathy was seen with T-DXd, followed by T-DM1 and SG.
Keywords
antibody–drug conjugate, breast cancer, meta-analysis, peripheral neuropathy
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[13] Krop IE, Beeram M, Modi S, et al. Phase I Study of Trastuzumab-DM1, an HER2 Antibody-Drug Conjugate, Given Every 3 Weeks to Patients With HER2-Positive Metastatic Breast Cancer. J Clin Oncol. 2010;28(16):2698-2704. doi:10.1200/JCO.2009.26.2071
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[20] Jain S, Shah AN, Santa-Maria CA, et al. Phase I study of alpelisib (BYL-719) and trastuzumab emtansine (T-DM1) in HER2-positive metastatic breast cancer (MBC) after trastuzumab and taxane therapy. Breast Cancer Res Treat. 2018;171(2):371-381. doi:10.1007/s10549-018-4792-0
[21] Kojima Y, Yoshie R, Kawamoto H, et al. Trastuzumab Emtansine (T-DM1) Plus S-1 in Patients with Trastuzumab-Pretreated HER2-Positive Advanced or Metastatic Breast Cancer: A Phase Ib Study. Oncology. 2019;96(6):309-317. doi:10.1159/000497276
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[25] Hk A, Sh S, Kj S, et al. Response Rate and Safety of a Neoadjuvant Pertuzumab, Atezolizumab, Docetaxel, and Trastuzumab Regimen for Patients With ERBB2-Positive Stage II/III Breast Cancer: The Neo-PATH Phase 2 Nonrandomized Clinical Trial. JAMA Oncol. 2022;8(9). doi:10.1001/jamaoncol.2022.2310
[26] Jenkins S, Zhang W, Steinberg SM, et al. Phase I Study and Cell-Free DNA Analysis of T-DM1 and Metronomic Temozolomide for Secondary Prevention of HER2-Positive Breast Cancer Brain Metastases. Clin Cancer Res Off J Am Assoc Cancer Res. 2023;29(8):1450-1459. doi:10.1158/1078-0432.CCR-22-0855
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[28] Padua TC de, Moschini M, Martini A, et al. Efficacy and toxicity of antibody-drug conjugates in the treatment of metastatic urothelial cancer: A scoping review. Urol Oncol. 2022;40(10):413-423. doi:10.1016/j.urolonc.2022.07.006
[29] Ma P, Tian H, Shi Q, et al. High risks adverse events associated with trastuzumab emtansine and trastuzumab deruxtecan for the treatment of HER2-positive/mutated malignancies: a pharmacovigilance study based on the FAERS database. Expert Opin Drug Saf. 2023;22(8):685-696. doi:10.1080/14740338.2023.2204228
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[32] Patel TA, Ensor JE, Creamer SL, et al. A randomized, controlled phase II trial of neoadjuvant ado-trastuzumab emtansine, lapatinib, and nab-paclitaxel versus trastuzumab, pertuzumab, and paclitaxel in HER2-positive breast cancer (TEAL study). Breast Cancer Res BCR. 2019;21(1):100. doi:10.1186/s13058-019-1186-0
[33] Diéras V, Miles D, Verma S, et al. Trastuzumab emtansine versus capecitabine plus lapatinib in patients with previously treated HER2-positive advanced breast cancer (EMILIA): a descriptive analysis of final overall survival results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2017;18(6):732-742. doi:10.1016/S1470-2045(17)30312-1
[34] Hurvitz SA, Martin M, Symmans WF, et al. Neoadjuvant trastuzumab, pertuzumab, and chemotherapy versus trastuzumab emtansine plus pertuzumab in patients with HER2-positive breast cancer (KRISTINE): a randomised, open-label, multicentre, phase 3 trial. Lancet Oncol. 2018;19(1):115-126. doi:10.1016/S1470-2045(17)30716-7
[35] Perez EA, Barrios C, Eiermann W, et al. Trastuzumab emtansine with or without pertuzumab versus trastuzumab with taxane for human epidermal growth factor receptor 2-positive advanced breast cancer: Final results from MARIANNE. Cancer. 2019;125(22):3974-3984. doi:10.1002/cncr.32392
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