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Clinical Data Analysis of Neuropathy Related to Cancer Drugs: A Retrospective Study Using the TMUCRD
Other Title
Clinical Data Analysis of Neuropathy Related to Cancer Drugs: A Retrospective Study Using the TMUCRD
Type
thesis
Date Issued
2025-07-15
Author(s)
Ndabenhle Cedric Dlamini
Advisor
葉篤學 ;吳天元
Subjects
系所名稱：藥學系碩士班
Publisher
藥學系碩士班
Description
學位別：碩士
口試委員：吳天元; 邵于宣; 陳香吟; 楊軒佳; 葉篤學
關鍵字：Cancer、Tyrosine Kinase Inhibitors、TKI-induced Neuropathy、Taipei Medical University Clinical Research Database
口試委員：吳天元; 邵于宣; 陳香吟; 楊軒佳; 葉篤學
關鍵字：Cancer、Tyrosine Kinase Inhibitors、TKI-induced Neuropathy、Taipei Medical University Clinical Research Database
Abstract
Background
Neuropathy is a significant adverse event in oncology patients undergoing treatment with tyrosine
kinase inhibitors (TKIs), yet its risk factors remain context-dependent. This study aimed to identify
factors associated with neuropathy in a TKI-treated cancer cohort and examine correlations with other
TKI-related adverse events.
Objective
To quantify the incidence of neuropathy among TKI-treated cancer patients, identify associated
risk factors, compare rates across TKI types, and evaluate the relationship between neuropathy and other
TKI-related adverse events.
Methods
This retrospective cohort study utilized data from the Taipei Medical University Clinical Research
Database (TMUCRD), including its embedded cancer registry, to examine inpatient and outpatient
cancer patients treated with TKIs from January 2016 to June 2019. To exclude pre-exposure to TKI
therapy, a 12-month washout period was applied before the index date. Eligible patients were ≥20 years,
diagnosed with cancer from the registry, initiating first-time TKI therapy, had documented use of
neuropathy relief medication, and had complete comorbidity records. Patients with pre-existing
neuropathy or those who discontinued TKI within one month for unrelated reasons were excluded. Data
included demographics, comorbidities, cancer type/stage, and adverse events identified via ICD codes.
Results
Of 704 patients, 159 (22.6%) developed TKI-induced neuropathy. A weighted stepwise logistic
regression identified younger age (OR = 0.987, p = 0.009), diabetes mellitus (OR = 1.80, p = 0.002),
stomatitis (OR = 2.96, p = 0.025), cough (OR = 2.60, p = 0.006), constipation (OR = 1.59, p = 0.022),
and docetaxel use (OR = 2.91, p = 0.008) as significant risk factors. The model showed modest
discrimination (AUC = 0.600) and acceptable calibration (Hosmer–Lemeshow p = 0.070). No individual
adverse event was strongly correlated with neuropathy (all ρ > 0.05).
Conclusion
Younger age, diabetes, and symptoms such as stomatitis, cough, and constipation, as well as
docetaxel use, may be risk factors of TKI-induced neuropathy. These findings support improved risk
identification and targeted monitoring strategies in real-world oncology practice.
Neuropathy is a significant adverse event in oncology patients undergoing treatment with tyrosine
kinase inhibitors (TKIs), yet its risk factors remain context-dependent. This study aimed to identify
factors associated with neuropathy in a TKI-treated cancer cohort and examine correlations with other
TKI-related adverse events.
Objective
To quantify the incidence of neuropathy among TKI-treated cancer patients, identify associated
risk factors, compare rates across TKI types, and evaluate the relationship between neuropathy and other
TKI-related adverse events.
Methods
This retrospective cohort study utilized data from the Taipei Medical University Clinical Research
Database (TMUCRD), including its embedded cancer registry, to examine inpatient and outpatient
cancer patients treated with TKIs from January 2016 to June 2019. To exclude pre-exposure to TKI
therapy, a 12-month washout period was applied before the index date. Eligible patients were ≥20 years,
diagnosed with cancer from the registry, initiating first-time TKI therapy, had documented use of
neuropathy relief medication, and had complete comorbidity records. Patients with pre-existing
neuropathy or those who discontinued TKI within one month for unrelated reasons were excluded. Data
included demographics, comorbidities, cancer type/stage, and adverse events identified via ICD codes.
Results
Of 704 patients, 159 (22.6%) developed TKI-induced neuropathy. A weighted stepwise logistic
regression identified younger age (OR = 0.987, p = 0.009), diabetes mellitus (OR = 1.80, p = 0.002),
stomatitis (OR = 2.96, p = 0.025), cough (OR = 2.60, p = 0.006), constipation (OR = 1.59, p = 0.022),
and docetaxel use (OR = 2.91, p = 0.008) as significant risk factors. The model showed modest
discrimination (AUC = 0.600) and acceptable calibration (Hosmer–Lemeshow p = 0.070). No individual
adverse event was strongly correlated with neuropathy (all ρ > 0.05).
Conclusion
Younger age, diabetes, and symptoms such as stomatitis, cough, and constipation, as well as
docetaxel use, may be risk factors of TKI-induced neuropathy. These findings support improved risk
identification and targeted monitoring strategies in real-world oncology practice.