Researchers at the Indiana University Melvin and Bren Simon Comprehensive Cancer Center have found that docetaxel is associated with less neuropathy in Black breast cancer patients compared to paclitaxel. The study, presented at the 2024 American Society of Clinical Oncology Annual Meeting, suggests a potential shift in the standard of care to improve outcomes and reduce disparities for this population.
Addressing Disparities in Breast Cancer Treatment
Breast cancer is the most common cancer diagnosis among women in the United States. Black women often face disparate outcomes and are more prone to experiencing neuropathy, a side effect of chemotherapy that causes numbness, tingling, and pain in the hands and feet. This condition is a primary reason patients cannot complete their prescribed chemotherapy, compromising cure rates.
"The EAZ171 clinical study was built off about a decade of work at IU, including a large breast cancer trial that showed that Black patients or patients of African descent were markedly more likely to get toxicity from chemotherapy, and particularly taxane-induced peripheral neuropathy," said Dr. Bryan P. Schneider, the Vera Bradley Professor of Oncology at the IU School of Medicine.
Docetaxel vs. Paclitaxel: A Significant Difference
The study, EAZ171, focused solely on women who self-identified as Black or African American. The results indicated that docetaxel was associated with significantly less neuropathy compared to paclitaxel, which has been the standard of care. Less neuropathy also meant fewer dose reductions of the life-saving therapy.
"The most important implication from this study for Black women with breast cancer is that we found that a specific chemotherapy drug, docetaxel, was associated with significantly less neuropathy compared to a drug called paclitaxel," said Dr. Tarah J. Ballinger, the Vera Bradley Foundation Scholar in Breast Cancer Research at the IU School of Medicine. "We saw less neuropathy, and we saw less dose reductions of life-saving therapy."
Patient Involvement and Study Design
Researchers collaborated with Black patient advocates, including the Indianapolis-based organization Pink-4-Ever Ending Disparities, in the trial design and patient recruitment. Focus groups helped inform the study’s design, recruitment, and educational materials, which included a social media campaign featuring Black women with breast cancer.
Implications for Future Treatment
The findings suggest that docetaxel may be the preferred drug specifically for Black women with breast cancer. This shift has the potential to improve disparities in breast cancer outcomes.
"Moving forward, this is potentially a way that we can improve disparities in breast cancer outcomes," Ballinger said.
A Patient's Perspective
Saysha Wright, one of the first women to enroll in the trial, shared her experience with taxane-based chemotherapy. She described the neuropathy as a temporary feeling of tingling and numbness in her fingers and toes, which impacted her daily activities. Wright expressed gratitude that her participation in the clinical trial has contributed to a new understanding of how to improve breast cancer treatments for Black women.
Moving Towards Personalized Medicine
Dr. Schneider emphasized the importance of identifying the right drug for the right patient at the right time, embracing the idea that patients should not only live longer and be cured but also live well. This study represents a step towards personalized medicine and addressing the unique needs of Black women with breast cancer.
