Supportive Care in Cancer

, Volume 22, Issue 5, pp 1223–1231

Oral alpha-lipoic acid to prevent chemotherapy-induced peripheral neuropathy: a randomized, double-blind, placebo-controlled trial

  • Ying Guo
  • Desiree Jones
  • J. Lynn Palmer
  • Arthur Forman
  • Shaker R. Dakhil
  • Maria R. Velasco
  • Matthias Weiss
  • Paul Gilman
  • G. M. Mills
  • Stephen J. Noga
  • Cathy Eng
  • Michael J. Overman
  • Michael J. Fisch
Original Article

Abstract

Objectives

Chemotherapy-induced peripheral neuropathy is frequently a dose-limiting factor in cancer treatment and may cause pain and irreversible function loss in cancer survivors. We tested whether alpha-lipoic acid (ALA) could decrease the severity of peripheral neuropathy symptoms in patients undergoing platinum-based chemotherapy.

Methods

Cancer patients 18 years or older were randomly selected to receive either 600 mg ALA or a placebo three times a day orally for 24 weeks while receiving chemotherapy regimens including cisplatin or oxaliplatin. Neuropathy was measured by the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) scale and the NCI Common Toxicity Criteria for Adverse Events neurotoxicity grades. Results from timed functional tests and the Brief Pain Inventory (BPI) were secondary endpoints.

Results

Seventy of 243 (29 %) patients completed the study (24 weeks). Both the ALA and the placebo arms had a comparable drop-out rate. No statistically significant differences were found between the ALA and the placebo groups for FACT/GOG-Ntx scores, BPI scores, and patients' functional outcomes.

Conclusion

This strategy of oral ALA administration was ineffective at preventing neurotoxicity caused by oxaliplatin or cisplatin. High attrition rates due to poor patient compliance and manner of dosage administration in this trial demonstrated a lack of feasibility for this intervention. Future studies to explore ALA as a neuroprotective agent should take heed of the barriers confronted in this study.

Keywords

Chemotherapy-induced peripheral neuropathy Sensory neuropathy toxicity Alpha-lipoic acid Oxaliplatin Neuropathy 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Ying Guo
    • 1
  • Desiree Jones
    • 2
  • J. Lynn Palmer
    • 1
  • Arthur Forman
    • 3
  • Shaker R. Dakhil
    • 4
  • Maria R. Velasco
    • 5
  • Matthias Weiss
    • 6
  • Paul Gilman
    • 7
  • G. M. Mills
    • 8
  • Stephen J. Noga
    • 9
  • Cathy Eng
    • 10
  • Michael J. Overman
    • 3
  • Michael J. Fisch
    • 3
  1. 1.The University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.The University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.The University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Cancer Center of KansasWichitaUSA
  5. 5.Cancer Care SpecialistsDecaturUSA
  6. 6.Marshfield ClinicMarshfieldUSA
  7. 7.Main Line Oncology Hematology AssociatesWynnewoodUSA
  8. 8.Louisiana State University Feist-Weiller Cancer CenterShreveportUSA
  9. 9.Alvin and Lois Lapidus Cancer InstituteBaltimoreUSA
  10. 10.Department of GI Medical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

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