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

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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.

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Acknowledgments

This study was conducted as a collaborative trial of MD Anderson Cancer Center and the MD Anderson Cancer Center Community Clinical Oncology Program Research Base and was supported in part by NCI grant U10CA045809. MD Anderson is supported in part by the National Institutes of Health through a Cancer Center Support Grant, CA016672. The ALA and placebo were provided by Jarrow Formulas, Inc., without charge.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1414, Houston, TX, 77030, USA

    Ying Guo & J. Lynn Palmer

  2. The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 410, Houston, TX, 77030, USA

    Desiree Jones

  3. The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Arthur Forman, Michael J. Overman & Michael J. Fisch

  4. Cancer Center of Kansas, 818N. Emporia #403, Wichita, KS, 67214, USA

    Shaker R. Dakhil

  5. Cancer Care Specialists, 1990 E Lake Shore Drive, Decatur, IL, 62526, USA

    Maria R. Velasco

  6. Marshfield Clinic, 1000N Oak Ave, Marshfield, WI, 54449, USA

    Matthias Weiss

  7. Main Line Oncology Hematology Associates, 100 Lancaster Avenue, 1 Medical Science Building, Wynnewood, PA, 19096, USA

    Paul Gilman

  8. Louisiana State University Feist-Weiller Cancer Center, 1501 Kings Highway, Shreveport, LA, 71130, USA

    G. M. Mills

  9. Alvin and Lois Lapidus Cancer Institute, 2401W. Belvedere Avenue, Baltimore, MD, 21215, USA

    Stephen J. Noga

  10. Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 426, Houston, TX, 77030, USA

    Cathy Eng

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  1. Ying Guo
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  2. Desiree Jones
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Corresponding author

Correspondence to Desiree Jones.

Additional information

This paper was presented previously as an oral abstract at the American Society of Clinical Oncology Annual Conference, Chicago, Illinois, 2011.

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Guo, Y., Jones, D., Palmer, J.L. et al. Oral alpha-lipoic acid to prevent chemotherapy-induced peripheral neuropathy: a randomized, double-blind, placebo-controlled trial. Support Care Cancer 22, 1223–1231 (2014). https://doi.org/10.1007/s00520-013-2075-1

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  • DOI: https://doi.org/10.1007/s00520-013-2075-1

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