Factors associated with taxane-associated acute pain syndrome in pancreatic cancer patients receiving gemcitabine and nab-paclitaxel.

PURPOSE: Taxane-associated acute pain syndrome (T-APS) is a common adverse event in patients treated with gemcitabine (GEM) + nanoparticle albumin-bound paclitaxel (nab-PTX) for pancreatic cancer. As several T-APS risk factors, such as age, cancer type, and taxane dose or formulation, differ between pancreatic cancer and other malignancies in previous studies, we aimed to identify factors associated with T-APS in a real-world setting of GEM + nab-PTX treatment for pancreatic cancer.

METHODS

We retrospectively analyzed 394 patients with pancreatic cancer receiving GEM + nab-PTX. The primary endpoint was the identification of factors associated with all-grade T-APS. Symptom incidence was also compared across specific patient groups.

RESULTS

T-APS occurred in 26.1% of patients after the first GEM + nab-PTX administration (grade 1: 21.6%; grade 2: 4.6%). Among patients with T-APS, 39.8% received medication, with more than two-thirds reporting symptom relief. Multivariable logistic regression analyses identified body mass index (BMI) ≥ 25 kg/m2 as a risk factor and baseline use of mild analgesics (non-steroidal anti-inflammatory drugs [NSAIDs] and/or acetaminophen) as a preventive factor (adjusted odds ratio, 2.98; 95% confidence interval, 1.68-5.31; P = 0.0002 for BMI, 0.48; 0.26-0.89; P = 0.02 for mild analgesics). A subgroup analysis comparing baseline NSAIDs and acetaminophen in patients receiving mild analgesic monotherapy showed no significant difference (P = 0.49).

CONCLUSION

Our study identified BMI ≥ 25 kg/m2 as a risk factor and baseline use of mild analgesics as a preventive factor for T-APS development in a real-world GEM + nab-PTX regimen for pancreatic cancer.