Association between Body Composition and Peripheral Neurotoxicity in Cancer Patients from North China Taking Nab-Paclitaxel

Abstract

Determine the association of lean body mass (LBM) on the incidence and severity of peripheral neurotoxicity in cancer patients who received nab-paclitaxel alone or combined with cisplatin or carboplatin. This prospective clinical study examined 32 cancer patients classified into a sarcopenia or non-sarcopenia group according to the Asian L3 vertebra skeletal muscle index (L3-SMI) at Ordos Central Hospital (China) from December 2020–2021, to compare the incidence and severity of neurotoxicity and analizing the relationship between nab-paclitaxel dose per kg LBM and neurotoxicity. There were 18 patients (56.25%) in the sarcopenia group and 14 (43.75%) in the non-sarcopenia group. The incidences of peripheral and severe neurotoxicity were higher in the sarcopenia group (both P < 0.05). Patients in three different body surface area (BSA) groups received the same nab-paclitaxel dose (260 mg/m² BSA). However, when patients were divided into three groups according to LBM, they received different doses (low-LBM: 15.18 mg/kg LBM, middle-LBM: 12.82 mg/kg LBM, and high-LBM: 11.14 mg/kg LBM). The incidence of grade-C or higher neurotoxicity of these three groups was 61.54% (8/13), 20.00% (1/5), and 11.11% (1/9). Sarcopenia and a higher dose of nab-paclitaxel per kg LBM were associated with peripheral and severe neurotoxicity. Chemotherapy dosing based on body composition may reduce neurotoxicity in patients receiving nab-paclitaxel.

Registration number of Clinical Trial: ChiCTR2000040918.

Acknowledgments

The authors express their sincere gratitude to all bedside clinicians who helped recruit patients and collect data without receipt of financial compensation. The authors also thank all the patients for their cooperation and Medjaden Inc. for help with language editing of the manuscript.

Authors’ Contributions

JiayuanGuo: Formal analysis, Investigation, Writing - Original Draft. JuanZhao: Resources. MingGu: Resources. JixiangHou: Software. TingXu: Investigation. YingJiang: Resources. Caihong Jiang: Resources. Hui Li: Resources. Xiaorong Li: Resources. Guang liu: Resources. Lanzhen Zhao: Resources. Gaowa Jin: Supervision. Yongzhi Shi:Investigation. Ting Liu:Resources. Zhenhao Li: Investigation. Zewei Zhang:Investigation. Quanfu Li: Conceptualization, Resources, Writing - Review & Editing, Project administration.

Disclosure Statement

All authors disclosed no relevant relationships.

Additional information

Funding

This work was supported by the Inner Mongolia Autonomous Region Graduate Research and Innovation Funding Project (SZ2020109); Ordos Health Commission Key Discipline Project.