BACKGROUND: Black patients with breast cancer experience higher rates of taxane-induced peripheral neuropathy (TIPN), which may compromise chemotherapy dose delivery and health-related quality of life (HRQOL). Using the prospective ECOG-ACRIN EAZ171 trial, the authors examined whether patient-reported TIPN predicts dose reductions and longer-term declines in HRQOL and physical function. METHODS: EAZ171 enrolled 249 Black patients planned for (neo)adjuvant taxane; 239 with available patient-reported outcome (PRO) data were analyzed. TIPN was assessed during treatment using the Functional Assessment of Cancer Therapy GOG Neurotoxicity scale (FACT-GOG/NTx) (4-item, 11-item, and single items) and PRO-Common Terminology Criteria for Adverse Events numbness/tingling and interference. HRQOL (FACT-G) and physical function (PROMIS PF-10a) were measured through 12 months. Multivariable mixed-effects logistic models evaluated associations between TIPN, taxane dose reduction due to neuropathy, and 12-month HRQOL or physical function decline. RESULTS: All TIPN PROs were associated with dose reduction, with the FACT-GOG/NTx 4-item subscale showing the strongest association (odds ratio OR, 10.8; 95% CI, 4.5-25.9). Twelve-month PRO data were available for 140 patients (59%). Neuropathy reported during treatment was not associated with reduced HRQOL or physical function at 12 months; however, persistent neuropathy at 12 months was associated with worse HRQOL (OR, 5.05; 95% CI, 1.33-19.17) and physical function (OR, 5.29; 95% CI, 1.57-17.83). CONCLUSIONS: TIPN was common and strongly predicted taxane dose reduction in Black patients. The FACT-GOG/NTx 4-item subscale performed best, supporting its use in future trials. Although early TIPN did not predict long-term functional decline, persistent neuropathy adversely affected HRQOL, underscoring the importance of early identification and supportive care to improve dose delivery and equity in breast cancer outcomes.
Ballinger et al. (2026) studied this question.