A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I

Deirdre R. Pachman, Travis Dockter, Patricia J. Zekan, Briant Fruth, Kathryn J Ruddy, Lauren E. Ta, Jacqueline M. Lafky, Todor Dentchev, Nguyet Anh Le-Lindqwister, William M. Sikov, Nathan P Staff, Andreas S Beutler, Charles Lawrence Loprinzi

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Purpose: Paclitaxel is associated with both an acute pain syndrome (P-APS) and chronic chemotherapy-induced peripheral neuropathy (CIPN). Given that extensive animal data suggest that minocycline may prevent chemotherapy-induced neurotoxicity, the purpose of this pilot study was to investigate the efficacy of minocycline for the prevention of CIPN and the P-APS. Methods: Patients with breast cancer were enrolled prior to initiating neoadjuvant or adjuvant weekly paclitaxel for 12 weeks and were randomized to receive minocycline 200 mg on day 1 followed by 100 mg twice daily or a matching placebo. Patients completed (1) an acute pain syndrome questionnaire daily during chemotherapy to measure P-APS and (2) the EORTC QLQ-CIPN20 questionnaire at baseline, prior to each dose of paclitaxel, and monthly for 6 months post treatment, to measure CIPN. Results: Forty-seven patients were randomized. There were no remarkable differences noted between the minocycline and placebo groups for the overall sensory neuropathy score of the EORTC QLQ-CIPN20 or its individual components, which evaluate tingling, numbness and shooting/burning pain in hands and feet. However, patients taking minocycline had a significant reduction in the daily average pain score attributed to P-APS (p = 0.02). Not only were no increased toxicities reported with minocycline, but there was a significant reduction in fatigue (p = 0.02). Conclusions: Results of this pilot study do not support the use of minocycline to prevent CIPN, but suggest that it may reduce P-APS and decrease fatigue; further study of the impact of this agent on those endpoints may be warranted.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalSupportive Care in Cancer
DOIs
StateAccepted/In press - May 27 2017

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Keywords

  • Chemotherapy-induced peripheral neuropathy
  • Minocycline
  • Paclitaxel neuropathy

ASJC Scopus subject areas

  • Oncology

Cite this

Pachman, D. R., Dockter, T., Zekan, P. J., Fruth, B., Ruddy, K. J., Ta, L. E., Lafky, J. M., Dentchev, T., Le-Lindqwister, N. A., Sikov, W. M., Staff, N. P., Beutler, A. S., & Loprinzi, C. L. (Accepted/In press). A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I. Supportive Care in Cancer, 1-10. https://doi.org/10.1007/s00520-017-3760-2