ArticleMaedica2026
Treatment-Limiting Taxane-Induced Peripheral Neuropathy: Timing, Severity and Clinical Predictors in Patients Receiving Neoadjuvant TCHP.
Article in Maedica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and clinically significant neurotoxicity associated with taxane-based chemotherapy, which is frequently leading to treatment modification or discontinuation. In the neoadjuvant setting, treatment-limiting CIPN may compromise the delivery of planned therapy. However, detailed data on the timing, severity and clinical predictors of severe CIPN remain limited, particularly in real-world populations. Methods: We conducted a retrospective single-institution cohort study including consecutive patients with HER2-positive breast cancer treated with neoadjuvant docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP). The analysis was restricted to patients who developed CIPN requiring discontinuation of docetaxel. Neuropathy severity was graded according to CTCAE v6.0 and categorized as grade 2 or grade 3. Clinical variables associated with severe neuropathy were evaluated using Firth penalized logistic regression. Results: Among 843 patients treated with neoadjuvant TCHP, 180 (21.4%) developed treatment-limiting CIPN and were included in the analysis. Grade 3 neuropathy occurred in 32 patients (17.8%). Severe CIPN was associated with higher body mass index, diabetes mellitus, pre-existing peripheral neuropathy and cardiovascular comorbidities. Neuropathy frequently developed early during treatment, with a substantial proportion of severe cases occurring within the first two cycles or present at baseline. Patients with grade 3 CIPN received fewer cycles of chemotherapy, reflecting early treatment discontinuation. Conclusions: Treatment-limiting CIPN during neoadjuvant taxane-based therapy is often an early event and is strongly associated with patient-related vulnerability factors, particularly metabolic and neurologic comorbidities. These findings support the need for early risk stratification and closer neurologic monitoring in patients at increased risk for severe neurotoxicity.
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