Coasting related to taxane-induced peripheral neuropathy in patients with breast cancer: a systematic review

BACKGROUND AND PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose limiting adverse effect that may be transient or become persistent after the treatment ended. The taxane paclitaxel induces CIPN in 57-83% of patients treated. The neuropathy may debut or progress after the end of treatment (EOT), known as coasting, but little is known about the incidence of this phenomenon. The aim of this review is to examine the incidence and severity of coasting in CIPN in patients with breast cancer. Patient/material and methods: MEDLINE, Embase, clinicaltrials.gov, and medrivx.org were searched using terms related to taxanes, adverse effects, and breast cancer. Studies had to have a follow-up time of at least 3 months after EOT and patients had to have received taxanes in monotherapy. Additionally, studies had to be longitudinal and describe the neuropathy assessment method and timing.

RESULTS: A total of 17 studies met the eligibility criteria, with 4,265 participants summarized. Of these, one study reported coasting events in 14.3% (n = 4) of patients. Eight studies reported no coasting events and eight were unclear.

INTERPRETATION: Few studies reported on coasting in CIPN. There may be several reasons for this, including the timing and choice of assessment methods, confounding factors, and the possible rarity of the phenomenon. More information is needed about coasting in CIPN to better characterize the neuropathies, guide patient and doctor decisions, and aid in the development of interventions toward CIPN.