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The impact of obesity on neuropathy outcomes for paclitaxel- and oxaliplatin-treated cancer survivors

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Abstract

Purpose

Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect of neurotoxic cancer treatment, often impacting treatment tolerability and patient functioning. Factors predicting an individual’s vulnerability for develo** CIPN remain ill-defined. However, patient characteristics may contribute to CIPN risk, with obesity being a prevalent patient comorbidity. This study was aimed at evaluate if being overweight (BMI ≥ 25 kg/m2) was associated with worse symptomatic, clinical, and functional CIPN following neurotoxic cancer treatment.

Methods

Three hundred seventy-nine cancer survivors were assessed 5 (IQR 3–5) months post oxaliplatin or paclitaxel treatment via comprehensive patient-reported, clinical, and functional CIPN measures. Patients classified as overweight (BMI ≥ 25 kg/m2) were compared to those within the normal BMI range (< 25 kg/m2). Multilinear regression was conducted to evaluate the association between patient clinical factors and CIPN severity.

Results

Most patients reported CIPN symptoms (78%), with deficits evident on clinical examination. Overweight patients (n = 242, 63.8%) had significantly worse CIPN across symptomatic, objective clinical, and functional outcomes compared to those with a normal BMI (p < .05). In multivariate linear regression, older age (B = .088, 95%CI = .053–.122, p < .001), larger waist circumference (B = .030, 95%CI = .001–.059, p < .05), and larger BSA (B = 2.41, 95%CI = .34–04.48, p < .05) were associated with CIPN. Diabetes and BMI were significant on univariate analysis but not in the final models.

Conclusions

Overweight patients represent a large proportion of cancer survivors who may be particularly impacted by CIPN, requiring closer monitoring and referral to supportive services. Accessible data such as a patient’s general and abdominal obesity status may aid in formulating personalized treatment.

Implications for Cancer Survivors

Identifying routinely measured patient characteristics which may contribute to an individual’s CIPN risk profile could assist with informing treatment decisions.

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Funding

This study was supported by a Cancer Institute NSW Program Grant (14/TPG/1-05) and a National Health and Medical Research Council of Australia (NHMRC) Project Grant (#1080521). SBP is supported by a NHMRC Career Development Fellowship (#1148595). MCK is supported by a NHMRC Practitioner Fellowship (1156093) and by ForeFront, a large collaborative research group dedicated to the study of neurodegenerative diseases and funded by the National Health and Medical Research Council of Australia Program Grant (#1132524).

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Authors and Affiliations

  1. Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2050, Australia

    Hannah C. Timmins, Tiffany Li, Matthew C. Kiernan & Susanna B. Park

  2. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia

    David Goldstein, Terry Trinh, David Mizrahi & Michael Friedlander

  3. Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia

    David Goldstein

  4. Chris O’Brien Lifehouse, Sydney, Australia

    Michelle Harrison & Lisa G Horvath

  5. Department of Medical Oncology, Liverpool Hospital, Liverpool, Australia

    Michelle Harrison & Michael Friedlander

  6. Sydney Medical School, University of Sydney, Camperdown, Australia

    Lisa G Horvath & Matthew C. Kiernan

  7. Royal Prince Alfred Hospital, Camperdown, Australia

    Lisa G Horvath & Matthew C. Kiernan

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  1. Hannah C. Timmins
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Timmins, H.C., Li, T., Goldstein, D. et al. The impact of obesity on neuropathy outcomes for paclitaxel- and oxaliplatin-treated cancer survivors. J Cancer Surviv 16, 223–232 (2022). https://doi.org/10.1007/s11764-021-01012-y

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