Paclitaxel - induced peripheral neuropathy in a breast cancer patient: A case report

Background: Paclitaxel is one among the drugs considered in the management of breast cancer. The issue, however, arises when the beneficial effect of this drug in any therapy is limited by the development of chemotherapy-induced peripheral neuropathy. PIPN is mainly sensory, dose-related, and has a significant impact on the patient's quality of life. Case Presentation: A 52-year-old female with breast cancer developed neuropathic symptoms after two cycles of paclitaxel. Patient-reported symptoms included burning pain, numbness, and tingling of the extremities. Neurological examination and nerve conduction studies revealed axonal sensory neuropathy of the peripheral type. Differential laboratory diagnoses excluded the presence of diabetes, thyroid dysfunction, renal impairment, or vitamin deficiencies. An assessment of causality using the Naranjo scale gave a score of 6, and application of the WHOUppsala Monitoring Centre (UMC) criteria classified the reaction as probable, i.e., neuropathy related to paclitaxel. Management and Outcome: Pharmacological intervention comprising pregabalin, gabapentin, and amitriptyline, together with folic acid, vitamin B-complex, and calcium supplementations led to symptom amelioration within about two weeks. After stabilization, paclitaxel was readministered at 20 percent dose reduction. The patient tolerated the modified regimen well, no further progression of neuropathy, and thus, could continue with cancer treatment. Conclusion: This case reveals that early recognition with a structured approach in the evaluation of PIPN is important. Pharmacological treatment targeted at the symptoms, supportive supplementation, and chemotherapy dose modification allowed the patient to undergo effective anticancer therapy without compromising neurological safety. Hence, individualized management plans, interdisciplinary cooperation, and frequent clinical reviews are necessary to enhance treatment outcomes and preserve the quality of life in patients receiving taxane-based regimens. Keywords: Paclitaxel, Peripheral Neuropathy, Breast Cancer, Chemotherapy-Induced Neuropathy, Case Report