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Supportive Care in Cancer

, Volume 25, Issue 11, pp 3407–3416 | Cite as

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 Staff
  • Andreas S. Beutler
  • Charles L. LoprinziEmail author
Original Article

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.

Keywords

Minocycline Chemotherapy-induced peripheral neuropathy Paclitaxel neuropathy 

Notes

Acknowledgements

This trial was supported by the Breast Cancer Research Foundation and by the Altru Health Foundation and the University of North Dakota Athletics Department.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Deirdre R. Pachman
    • 1
  • Travis Dockter
    • 2
  • Patricia J. Zekan
    • 3
  • Briant Fruth
    • 2
  • Kathryn J. Ruddy
    • 1
  • Lauren E. Ta
    • 4
  • Jacqueline M. Lafky
    • 1
  • Todor Dentchev
    • 5
  • Nguyet Anh Le-Lindqwister
    • 6
  • William M. Sikov
    • 7
  • Nathan Staff
    • 4
  • Andreas S. Beutler
    • 1
  • Charles L. Loprinzi
    • 1
    Email author
  1. 1.Department of OncologyMayo ClinicRochesterUSA
  2. 2.Department of StatisticsMayo ClinicRochesterUSA
  3. 3.Novant Health Forsyth Medical CenterWinston-SalemUSA
  4. 4.Department of NeurologyMayo ClinicRochesterUSA
  5. 5.Altru Health SystemGrand ForksUSA
  6. 6.Illinois CancerCare-PeoriaPeoriaUSA
  7. 7.Women & Infants Hospital of Rhode IslandProvidenceUSA

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