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A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I
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A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I
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Journal Article
A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I
2017
Overview
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.
Publisher
Springer Berlin Heidelberg,Springer,Springer Nature B.V
Subject
Anti-Bacterial Agents - pharmacology
/ Anti-Bacterial Agents - therapeutic use
/ Burning
/ Cancer
/ Efficacy
/ Fatigue
/ Female
/ Humans
/ Medicine
/ Minocycline - therapeutic use
/ Nursing
/ Oncology
/ Paclitaxel - adverse effects
/ Pain
/ Patients
/ Peripheral Nervous System Diseases - chemically induced
/ Shooting
