Exploring the toxicity and clinical outcomes of doxorubicin, cyclophosphamide, and taxane-based chemotherapies in women with breast cancer in Bangladesh

BackgroundIndividuals receiving chemotherapy for breast cancer frequently experience severe drug reactions, which exacerbates safety issues such as decreased quality of life, prolonged treatment, and reinforcement of negative emotions associated with therapy. The emergence of these issues is especially devastating in developing countries like Bangladesh, where the medication's safety profile is inadequate. The goal of the current study was to assess the real-time toxicological and clinical outcomes of doxorubicin, cyclophosphamide, and taxanes treated breast cancer patients in Bangladesh.MethodsAbout 151 breast cancer patients were recruited from the National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh, where 132 and 19 patients received doxorubicin-cyclophosphamide-paclitaxel and doxorubicin-cyclophosphamide-docetaxel chemotherapy regimen, respectively. Clinical responses were evaluated using Response Evaluation Criteria in Solid Tumors (RECIST), whereas chemotherapy-associated toxicities were graded according to the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0).ResultsThe most common non-hematological adverse events reported across the both treatment regimens were nausea, vomiting, diarrhea, and fatigue, along with several other symptoms. Anemia (61.93%) emerged as the most common hematological toxicity, followed by conditions like neutropenia (21.8%), leukocytosis (19.87%), and lymphocytosis (18.54%). Patients also experienced various organ and tissue specific toxicities, with liver, kidney, and heart complications being notable. These side effects contributed to significant health challenges during the course of treatment. Unfortunately, a number of patients passed away, with most of the deaths occurring within five years of their cancer diagnosis.ConclusionsIn conclusion, breast cancer patients in Bangladesh are experiencing numerous non-haematological and haematological side effects, which impacting overall patient wellbeing that contributed to notable challenges including death. Personalized treatment approach could therefore be helpful to mitigate side effects and improve overall patient's experience.