Abstract PS1-03-21: Patient-reported measures of taxane-induced peripheral neuropathy (TIPN) and risk of dose reductions or worsening quality of life in Black women with breast cancer: analysis from ECOG-ACRIN EAZ171

Abstract Introduction: Black patients with breast cancer experience significantly higher rates of taxane-induced peripheral neuropathy (TIPN), potentially impacting quality of life (HRQoL), physical functioning, and dose delivery of curative chemotherapy. Here, we utilize the prospective trial ECOG-ACRIN EAZ171 to determine whether patient-reported TIPN outcome measures (PROMs), and which PROM, predict dose reductions of taxane therapy and longer-term detriment to HRQoL and physical functioning in Black patients who are most impacted by TIPN. Methods: EAZ171 enrolled 249 Black patients planned to receive (neo)adjuvant taxane therapy. This PRO analysis includes patients receiving at least one dose of therapy with available PRO data (n= 239). PRO assessments included FACT-GOG/NTx 4-item and 11- item neurotoxicity subscales and PRO-CTCTAE numbness/tingling and interference at baseline and each cycle. FACT-G and PROMIS Physical Function short form 10a were administered at baseline, during treatment, and 1 year post treatment initiation. Occurrence of patient-reported TIPN was defined as a decrease in FACT-GOG/NTx 4-item subscale of 2 or more. Other measures of TIPN explored included NTx item 1, NTx item 2, total FACT-GOG/NTx 11-item subscale, PRO-CTCTAE numbness/tingling, and PRO-CTCAE neuropathy interference. Reduction in HRQoL or physical function at 12 months were defined as a decrease in FACT-G total score of >/= 7 or decrease in PROMIS PF T score of >/= 5, respectively. Multivariate logistic mixed effect models with random intercept were used to determine the association of patient-reported TIPN with 1) subsequent dose reduction of taxane therapy due to neuropathy, and 2) subsequent reduction in HRQoL or physical function at one year, Covariates included baseline neuropathy, taxane type, age, ECOG PS, BMI, disease stage, nodal status, and HgbA1c level. Results: Receipt of paclitaxel and ECOG PS of 1 (vs 0) were associated with dose reduction. All measures of neuropathy were correlated with dose reduction, with the FACT-GOG/NTx 4-item subscale being the most highly correlated in multivariate analysis (OR 10.8, 95% CI 4.5-25.90). Dose reductions were also correlated with increasing neuropathy by total FACT-GOG/Ntx score (OR 5.02, 95% CI 2.55-9.88), NTx item 1 (OR 6.10, 95% CI 2.96-12.57), NTx item 2 (OR 3.88, 95% CI 2.00-7.50), PRO-CTCTAE severity (OR 8.16, 95% CI 3.65-18.25), and PRO-CTCTAE interference (OR 5.64, 95% CI 2.89-10.98). PRO data available at 12 months was limited (n=140; 59%). Occurrence of patient-reported neuropathy by FACT-GOG/Ntx-4 during treatment was not associated with a reduction in HRQoL or physical function at 12 months; however, persistent neuropathy at 12 months was associated with reduced HRQoL (OR 5.05, 95% CI 1.33-19.17). Conclusions: The majority of Black women reported moderate or severe TIPN during treatment, which significantly predicted dose reduction of curative therapy. The FACT-GOG/NTx 4-item subscale correlated most highly with dose reduction, supporting its use in future trials. Patient-reported TIPN during therapy did not correlate with longer- term reductions in HRQoL or physical function at 12 months, perhaps due to lack of specificity of these items or low sample size and differential attrition. These findings support the potential impact of and need for a focus on careful evaluation of toxicity. We now plan to utilize the measures identified here to select patients in need of early supportive care to reduce TIPN’s impact on dose delivery in Black patients, potentially improving survival and racial equity in breast cancer. Citation Format: T. J. Ballinger, F. Zhao, G. Jiang, F. Shen, D. Cella, D. Peipert, K. D. Miller, A. Wolff, A. DeMichele, B. P. Schneider, L. Wagner. Patient-reported measures of taxane-induced peripheral neuropathy (TIPN) and risk of dose reductions or worsening quality of life in Black women with breast cancer: analysis from ECOG-ACRIN EAZ171 [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-03-21.