Taxane acute pain syndrome (TAPS) in patients receiving taxane-based chemotherapy for breast cancer-a systematic review.

Abstract

Taxane acute pain syndrome (TAPS) is characterized by myalgias and arthralgias starting 24-48h after taxane-based chemotherapy and lasting for 5-7days. Relatively little is known about its incidence and impact on quality of life. A systematic review was conducted evaluating the incidence of TAPS in breast cancer patients receiving taxane-based chemotherapy. Embase, Cochrane, and Ovid MEDLINE were searched from 1947 to July 2015. Data was sought from randomized controlled trials (RCTs), prospective and retrospective observational studies. Two reviewers independently screened citations and full text articles. Outcomes of interest were the incidence of TAPS and its impact on quality of life. Of 980 citations identified, 51 relevant studies (27,007 patients) were included. Data came from RCTs (12,357 patients), retrospective (6566 patients) and prospective observational studies (6210 patients). Study sample sizes ranged from 14 to 4149 patients (median 152). Given the significance between study heterogeneity, a meta-analysis was not performed. The incidence of TAPS varied between taxanes: paclitaxel (median 13.1%, range 0.9-86%), docetaxel (median 10.5%, range 3.6-70%), and nab-paclitaxel (26%, range 14-43%). In the metastatic setting, median incidence was 30% (range 5.4-73%), compared with 11.3% (range 0.9-86%) in the adjuvant setting. Three out of eight studies assessing quality of life demonstrated pain interference with daily activities. The incidence of TAPS varies between taxanes, regimens, and disease settings. In order to identify patients at the greatest risk of TAPS, and hence optimize its prevention and management, standardized methods of diagnosing and measuring TAPS are needed.