Breath alcohol concentrations in patients undergoing taxane chemotherapy: An observational pilot study (BrACT study)

Background: Taxane chemotherapy contains ethanol as a solvent and patients receiving this are at risk of elevated breath alcohol concentrations (BAC) and alcohol intoxication. This is the first Australian study using accredited testing methods provided by the Australian Federal Police (AFP) to determine if patients receiving taxanes have BAC exceeding the legal driving limit of 0.05%. Methods: In this prospective observational pilot study, BAC were tested on two consecutive chemotherapy administration days as follows: prior to, immediately post, 30 minutes post and if still elevated, 60 minutes post infusion. The breathalyser was provided by the AFP. An elevated BAC (>0.05%) was confirmed with a venous blood alcohol concentration. Demographic data, infusion details (rate, volume, dosage) and symptoms of alcohol intoxication immediately after the infusion were collected. Results: At a large Australian cancer centre between May to November 2016, 26 patients were recruited (81% female). Twenty patients had breast cancer, 5 prostate cancer and 1 lung cancer. Five had Asian ethnicity and 3 had underlying non-malignant liver disorders. Twenty received paclitaxel (11 as a single agent) and 6 docetaxel. BAC results are listed in the table. Of the 5 patients (19%) with an elevated BAC on both occasions, 2 had paclitaxel, 2 had carboplatin + paclitaxel, 1 had trastuzumab + paclitaxel. All 5 had early breast cancer, were of non-Asian ethnicity, were more likely to experience symptoms of alcohol intoxication compared to those who only had elevated BAC recorded on one occasion, and 3 consumed alcohol monthly or less.Table: 507PTimepoint 1Numbers with elevated BACMean BACRange BACPrior to chemotherapy0--Immediately post chemotherapy9 (34%)0.012[0.01-0.014]30 minutes post chemotherapy0--Timepoint 2Prior to chemotherapy0--Immediately post chemotherapy8 (31%)0.014[0.01–0.019]30 minutes post chemotherapy0--Elevated BAC on both days5 (19%)0.012[0.01-0.014] Open table in a new tab Conclusions: This prospective study in an Australian population showed that although 19% of taxane administrations led to a reproducible detectable BAC, none had levels above 0.05%. At 30 minutes post administration, all levels returned to normal. This pilot study is reassuring in that taxanes do not cause alcohol intoxication, although larger studies would be required to confirm this. Legal entity responsible for the study: Olivia Newton John Cancer & Wellness Centre Funding: None Disclosure: All authors have declared no conflicts of interest.