Personalized Treatment Leads to Less Nerve Damage for Black Women with Breast Cancer

For Black women with breast cancer, the chemotherapy drug docetaxel causes less nerve damage than the chemotherapy drug paclitaxel. This finding comes from a new study presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting.

“This really important study confirmed results from prior clinical trials that showed that when Black patients are treated with chemotherapy, they are more likely to develop numbness and tingling, also called neuropathy,” said ASCO expert Norah Lynn Henry, MD, PhD, FASCO, medical oncologist and interim Division Chief of Hematology/Oncology at the University of Michigan.

The study included 249 Black women with breast cancer. The women received treatment with either paclitaxel or docetaxel. More than 70% of the women had genetic differences that put them at higher risk for peripheral neuropathy, a type of nerve damage.

The study found that women who received docetaxel experienced less peripheral neuropathy than those who received paclitaxel. The women who received docetaxel also did not need their treatment doses reduced as often.

The researchers saw that peripheral neuropathy was more common in women who had a genetic difference that put them at higher risk for it. However, having this higher genetic risk did not seem to influence whether someone would ever develop the side effect.

Peripheral neuropathy affects daily life for people with cancer

Peripheral neuropathy is a common side effect of drugs used to treat cancer, such as chemotherapy. It happens when nerves become damaged and cannot send signals to the brain, spinal cord, and other parts of the body. This can cause numbness, pain, and tingling in the hands and feet.

Peripheral neuropathy can impact how you walk, get dressed, write, and perform other daily tasks. It can also cause emotional challenges in addition to physical ones. For people treated for cancer, peripheral neuropathy can last for weeks, months, or even years after treatment is completed.

Previous research has shown that Black people with breast cancer experience more peripheral neuropathy than people of other races. Research has also found that specific genetic differences could affect a person’s risk of developing neuropathy.

Black women with breast cancer need personalized cancer treatment

Breast cancer is the leading cause of cancer death in Black women. Black women are also more likely to die from breast cancer than people of any other race or ethnic group at every age.

"Clinical trials in the U.S. have suffered from a disproportionate lack of Black patient enrollment,” said lead study author Tarah Ballinger, MD, associate professor of clinical medicine and Vera Bradley Foundation Scholar in Breast Cancer Research at the Indiana University School of Medicine. “Lack of representation is problematic given significant disparities in cancer outcomes by race. Specifically, Black patients with breast cancer are significantly more likely to die of the disease and to experience significant toxicity. We sought to not just describe disparities but to expand our understanding of them so that we can improve equity in breast cancer care.”

The findings from this study help support the need to personalize treatment for Black women with breast cancer. Personalized cancer treatment is when the doctor decides which treatment to use based on the patient’s individual situation to meet the patient’s specific needs. Cancer treatment that is personalized to Black women can help reduce side effects. This can make treatment easier to manage and improve outcomes for patients.

“It is important for patients who are starting treatment with chemotherapy to talk with their oncologists when deciding which drugs make the most sense for them, to try to maximize their benefit from treatment and minimize their likelihood of developing long-term side effects,” said Dr. Henry.

It is important to continue learning about how cancer affects Black women and to seek ways to improve their cancer care. The VOICES of Black Women is a study led by the American Cancer Society that focuses on better understanding cancer and other health conditions among Black women. Results from this study will help inform how to improve the health of Black women for generations to come. Learn more about the VOICES of Black Women study.

Tips for managing peripheral neuropathy

While you cannot prevent peripheral neuropathy, there are things you can do to help manage it:

• Drink at least 8 cups of water a day.
• Eat fruits, vegetables, and whole grains to get enough fiber.
• Control your blood sugar if you have diabetes.
• Avoid or limit alcohol.
• Talk with your cancer care team about medication to relieve pain or discomfort.

Read a patient-friendly summary of this research.

Dr. Henry is an Associate Editor on ASCO’s Patient Information Editorial Board.