Evaluation of the impact of systemic dexamethasone dosage on docetaxel-induced hand-foot syndrome in patients with breast cancer

TL;DR

Higher doses of dexamethasone reduce the risk of hand-foot syndrome caused by docetaxel in breast cancer patients.

Contribution

This study demonstrates that systemic dexamethasone dosage has a dose-dependent preventive effect on docetaxel-induced hand-foot syndrome in breast cancer patients.

Findings

An 8 mg/day dexamethasone dose significantly reduced all-grade hand-foot syndrome compared to 4 mg/day.

Higher dexamethasone dosage was an independent preventive factor for hand-foot syndrome in logistic regression analysis.

Results were consistent in both all treatment cycles and the first cycle, confirmed in a propensity score-matched population.

Abstract

Hand-foot syndrome (HFS) is a frequently occurring and treatment-requiring adverse effect of docetaxel. We previously reported that systemic dexamethasone (DEX) prevents the other docetaxel-induced adverse inflammatory effects in a dose-dependent manner. This study aimed to evaluate the dose-dependent efficacy of systemic DEX in attenuating HFS in patients with breast cancer receiving docetaxel. Patients with breast cancer receiving docetaxel (75 mg/m2)-containing regimens (n = 111) were divided into 4 and 8 mg/day DEX groups, with each DEX dose administered on days 2–4, and analyzed retrospectively. Development of all-grade HFS in all treatment cycles was significantly lower in the 8 mg group (50.0%) than in the 4 mg group (73.0%, P = 0.03), with primary endpoint accomplishment. Moreover, its development in the first cycle was also lower in the 8 mg group than in the 4 mg group. These results were confirmed in a propensity score-matched population. Logistic regression analysis suggested higher DEX dosage as an independent preventive factor (adjusted odds ratio 0.35; 95% confidence interval 0.14–0.86, P = 0.02 for all cycles; 0.26, 0.11–0.63, P = 0.003 for the first cycle). Our study suggests that systemic DEX prevents the occurrence of docetaxel-induced HFS in patients with breast cancer in a dose-dependent manner in a real-world setting.

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