TY - JOUR
T1 - A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy
T2 - ACCRU study RU221408I
AU - Pachman, Deirdre R.
AU - Dockter, Travis
AU - Zekan, Patricia J.
AU - Fruth, Briant
AU - Ruddy, Kathryn J.
AU - Ta, Lauren E.
AU - Lafky, Jacqueline M.
AU - Dentchev, Todor
AU - Le-Lindqwister, Nguyet Anh
AU - Sikov, William M.
AU - Staff, Nathan
AU - Beutler, Andreas S.
AU - Loprinzi, Charles L.
N1 - Funding Information:
This trial was supported by the Breast Cancer Research Foundation and by the Altru Health Foundation and the University of North Dakota Athletics Department.
Publisher Copyright:
© 2017, Springer-Verlag Berlin Heidelberg.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - 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.
AB - 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.
KW - Chemotherapy-induced peripheral neuropathy
KW - Minocycline
KW - Paclitaxel neuropathy
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U2 - 10.1007/s00520-017-3760-2
DO - 10.1007/s00520-017-3760-2
M3 - Article
C2 - 28551844
AN - SCOPUS:85019711413
SN - 0941-4355
VL - 25
SP - 3407
EP - 3416
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 11
ER -