Risk factors of docetaxel-induced peripheral edema in non-small cell lung cancer treatment: a multi-institutional cohort study.

BACKGROUND

Peripheral edema is an adverse event associated with docetaxel (DTX). However, previous studies on DTX-induced peripheral edema have been limited to patients with breast cancer. Therefore, evaluation of symptoms in other cancer types is essential. We aimed to identify the factors associated with this symptom in patients with non-small cell lung cancer (NSCLC).

METHODS

This retrospective multicenter observational study evaluated 170 patients with NSCLC who received DTX between April 2014 and December 2024. The primary endpoint was factors associated with grade ≥ 2 DTX-induced peripheral edema during up to seven cycles. Additionally, we evaluated the factors for all-grade symptoms.

RESULTS

The incidences of grade ≥ 2 and all-grade DTX-induced peripheral edema were 13.5% and 30.0%. The median cumulative DTX dose at symptom onset was 144 (interquartile range, 60-254) mg/m2 for grade ≥ 2 DTX-induced peripheral edema and 120 (60-210) mg/m2 for all-grade symptoms. The Fine-Gray sub-distribution hazard models revealed that the co-administration of ramucirumab (RAM) was significantly associated with the incidence of DTX-induced peripheral edema (grade ≥ 2: sub-distribution hazard ratio [SDHR], 3.51; 95% confidence interval [CI], 1.34-9.24; P = 0.011) (all-grade: SDHR, 2.17; 95% CI, 1.20-3.92; P = 0.011). The Gray's test demonstrated that the cumulative incidence of DTX-induced peripheral edema was significantly higher in the DTX + RAM group than in the DTX monotherapy group (P = 0.003 and < 0.001 for grade ≥ 2 and all-grade symptoms, respectively).

CONCLUSIONS

We revealed that co-administration of RAM is a risk factor for DTX-induced peripheral edema in patients with NSCLC.