Chemotherapy-Induced Toxicities and Their Associations with Clinical and Non-Clinical Factors among Breast Cancer Patients in Vietnam

Understanding the burden and factors related to chemotherapy-induced toxicity is important in treatment planning for breast cancer patients. We conducted a prospective study among 396 newly diagnosed and chemotherapy-treated breast cancer patients recruited in two major cancer hospitals in northern Vietnam. Toxicities were captured through medical chart reviews and patient self-reports and graded using NCI CTCAE classification. Associations for sociodemographic and clinical factors with chemotherapy-induced toxicities during first-line chemotherapy were evaluated via multivariable logistic regression. Severe (i.e., grade ≥ 3) hematological (38.6%), and gastrointestinal (12.9%) toxicities were common. A pre-existing nephrological condition was significantly associated with the risk of severe hematological toxicity with adjusted odds ratios (OR) and 95% confidence intervals (CIs) of 2.30 (1.32–4.01). Patients living in rural areas had a lower risk of severe hematological toxicity (OR = 0.48; 95% CI, 0.30–0.77). Patients diagnosed with stage II and stage III–IV had a lower risk of severe gastrointestinal toxicity with ORs and 95% CIs of 0.26 (0.12–0.59) and 0.47 (0.20–1.10), respectively. Triple-negative/basal-like subtype was associated with a higher risk of severe hematological (OR = 3.15; 95% CI, 1.56–6.34) and gastrointestinal toxicities (OR = 3.60; 95% CI, 1.45–8.95) comparing to hormone receptor (HR)-positive HER2-negative subtype. Further research investigating underlying mechanisms would facilitate the development and delivery of personalized treatment and care plans.

[1]  X. Shu,et al.  Association of fruit, vegetable and animal food intakes with breast cancer risk overall and by molecular subtype among Vietnamese women. , 2022, Cancer Epidemiology, Biomarkers and Prevention.

[2]  X. Shu,et al.  Delay in the diagnosis and treatment of breast cancer in Vietnam , 2021, Cancer medicine.

[3]  Xiaoyi Wang,et al.  The effect of reduced RDI of chemotherapy on the outcome of breast cancer patients , 2020, Scientific Reports.

[4]  G. Yimer,et al.  Patterns of Anthracycline-Based Chemotherapy-Induced Adverse Drug Reactions and Their Impact on Relative Dose Intensity among Women with Breast Cancer in Ethiopia: A Prospective Observational Study , 2020, Journal of oncology.

[5]  Paul A. Harris,et al.  The REDCap consortium: Building an international community of software platform partners , 2019, J. Biomed. Informatics.

[6]  A. Sofić,et al.  Effects of adding taxane to anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer. , 2019, Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina.

[7]  Zhi-an Li,et al.  Anthracycline versus nonanthracycline adjuvant therapy for early breast cancer , 2018, Medicine.

[8]  A. Leo,et al.  Toxicity profile differences of adjuvant docetaxel/cyclophosphamide (TC) between Asian and Caucasian breast cancer patients , 2017, Asia-Pacific journal of clinical oncology.

[9]  Chris Brown,et al.  Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study , 2017, PloS one.

[10]  R. Jagsi,et al.  Treatment‐associated toxicities reported by patients with early‐stage invasive breast cancer , 2017, Cancer.

[11]  Katherine K. Kim,et al.  A Systematic Review of Emergency Department Use Among Cancer Patients , 2017, Cancer nursing.

[12]  M. Sisco,et al.  Systemic Therapy for Early-Stage Breast Cancer: What the Plastic Surgeon Should Know , 2017, Eplasty.

[13]  Sung-Bae Kim,et al.  Docetaxel‐based adjuvant therapy for breast cancer patients in Asia‐Pacific region: Results from 5 years follow‐up on Asia‐Pacific Breast Initiative‐I , 2016, Asia-Pacific journal of clinical oncology.

[14]  F. Montemurro,et al.  Self-evaluation of Adjuvant Chemotherapy-Related Adverse Effects by Patients With Breast Cancer. , 2016, JAMA oncology.

[15]  Tatiana Martins Tilli,et al.  Toward precision medicine of breast cancer , 2016, Theoretical Biology and Medical Modelling.

[16]  J. Bayo,et al.  Comparison of Doctors' and Breast Cancer Patients' Perceptions of Docetaxel, Epirubicin, and Cyclophosphamide (TEC) Toxicity , 2016, The breast journal.

[17]  H. Cohen,et al.  Effect of Pretreatment Renal Function on Treatment and Clinical Outcomes in the Adjuvant Treatment of Older Women With Breast Cancer: Alliance A171201, an Ancillary Study of CALGB/CTSU 49907. , 2016, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  C. Caldas,et al.  A nested cohort study of 6,248 early breast cancer patients treated in neoadjuvant and adjuvant chemotherapy trials investigating the prognostic value of chemotherapy-related toxicities , 2015, BMC Medicine.

[19]  Sung-Bae Kim,et al.  Safety Results of Docetaxel-(Taxotere®)-Based Chemotherapy in Early Breast Cancer Patients of Asia-Pacific Region: Asia-Pacific Breast Initiative II , 2015, Journal of breast cancer.

[20]  J. Sparano,et al.  Progress in adjuvant chemotherapy for breast cancer: an overview , 2015, BMC Medicine.

[21]  C. Gross,et al.  Association between renal function and chemotherapy-related toxicity in older adults with cancer. , 2017, Journal of geriatric oncology.

[22]  Gaetano Rocco,et al.  Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[23]  H. Cohen,et al.  Comorbidity, chemotherapy toxicity, and outcomes among older women receiving adjuvant chemotherapy for breast cancer on a clinical trial: CALGB 49907 and CALGB 361004 (alliance). , 2014, Journal of oncology practice.

[24]  G. Hortobagyi,et al.  Risk of hospitalization according to chemotherapy regimen in early-stage breast cancer. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[25]  M. Protani,et al.  Effect of obesity on toxicity in women treated with adjuvant chemotherapy for early-stage breast cancer: a systematic review , 2012, Breast Cancer Research and Treatment.

[26]  X. Pivot,et al.  Incidence and risk factors of anemia in patients with early breast cancer treated by adjuvant chemotherapy. , 2012, Breast.

[27]  M. Harrison,et al.  Emergency department visits for symptoms experienced by oncology patients: a systematic review , 2012, Supportive Care in Cancer.

[28]  L. Chow,et al.  Racial differences in acute toxicities of neoadjuvant or adjuvant chemotherapy in patients with early-stage breast cancer. , 2011, European journal of cancer.

[29]  M. Piccart,et al.  Long-term toxic effects of adjuvant chemotherapy in breast cancer. , 2011, Annals of oncology : official journal of the European Society for Medical Oncology.

[30]  G. Lyman,et al.  Effect of Primary Prophylactic Granulocyte-Colony Stimulating Factor Use on Incidence of Neutropenia Hospitalizations for Elderly Early-stage Breast Cancer Patients Receiving Chemotherapy , 2011, Medical care.

[31]  G. Lyman,et al.  Chemotherapy characteristics are important predictors of primary prophylactic CSF administration in older patients with breast cancer , 2011, Breast Cancer Research and Treatment.

[32]  G. Lyman,et al.  Effect of primary prophylactic G-CSF use on systemic therapy administration for elderly breast cancer patients , 2011, Breast Cancer Research and Treatment.

[33]  D. D. Rosa,et al.  Pharmacokinetic evaluation of doxorubicin plasma levels in normal and overweight patients with breast cancer and simulation of dose adjustment by different indexes of body mass. , 2010, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[34]  Isabelle Boutron,et al.  Reporting of safety results in published reports of randomized controlled trials. , 2009, Archives of internal medicine.

[35]  Kornelia Polyak,et al.  Breast cancer: origins and evolution. , 2007, The Journal of clinical investigation.

[36]  A. Colevas,et al.  Adverse event reporting in publications compared with sponsor database for cancer clinical trials. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[37]  D. Berry,et al.  Effect of screening and adjuvant therapy on mortality from breast cancer. , 2006, The New England journal of medicine.

[38]  P. Rothwell,et al.  External validity of randomised controlled trials: “To whom do the results of this trial apply?” , 2005, The Lancet.

[39]  J. Ajani,et al.  Recommended guidelines for the treatment of cancer treatment-induced diarrhea. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[40]  G. Lyman,et al.  Chemotherapy‐induced neutropenia , 2004, Cancer.

[41]  G. Lyman,et al.  Incidence and predictors of low dose-intensity in adjuvant breast cancer chemotherapy: a nationwide study of community practices. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[42]  D. Dale,et al.  Neutropenia: causes and consequences. , 2002, Seminars in hematology.

[43]  G. Bonadonna,et al.  Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up. , 1995, The New England journal of medicine.

[44]  W. Cheung,et al.  Impact of comorbidity on chemotherapy use and outcomes in solid tumors: a systematic review. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[45]  M. Ratain,et al.  Pharmacogenetics and pharmacogenomics of anticancer agents , 2009, CA: a cancer journal for clinicians.