Impact of Race on Bortezomib-Induced Peripheral Neuropathy

Introduction: A key dose-limiting toxicity of bortezomib is peripheral neuropathy, which is managed by prompt dose reduction or discontinuation. However, the risk factors for bortezomib-induced peripheral neuropathy remain unclear, and clinical trials consist primarily of Caucasian patients.

Methods: We conducted a retrospective descriptive study at the Zuckerberg San Francisco General Hospital in adults receiving subcutaneous bortezomib.

Results: Based on 47 subjects identified and 27 subjects included in the final analysis, the incidence and severity of bortezomib-induced peripheral neuropathy was higher in non-Caucasian patients compared to Caucasian patients (80-83% vs 25%; mean grade 1-1.8 vs 0.3). Of those developing peripheral neuropathy, black or African American patients had more severe peripheral neuropathy before bortezomib dose reduction.

Conclusions: Race may therefore be a risk factor for the development of bortezomib-induced peripheral neuropathy. This pilot study may facilitate follow-up studies to further characterize risk factors, allowing for a more precise risk-versus-benefit assessment of bortezomib therapy.