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A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I

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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.

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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.

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Authors and Affiliations

  1. Department of Oncology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    Deirdre R. Pachman, Kathryn J. Ruddy, Jacqueline M. Lafky, Andreas S. Beutler & Charles L. Loprinzi

  2. Department of Statistics, Mayo Clinic, Rochester, MN, USA

    Travis Dockter & Briant Fruth

  3. Novant Health Forsyth Medical Center, Winston-Salem, NC, USA

    Patricia J. Zekan

  4. Department of Neurology, Mayo Clinic, Rochester, MN, USA

    Lauren E. Ta & Nathan Staff

  5. Altru Health System, Grand Forks, ND, USA

    Todor Dentchev

  6. Illinois CancerCare-Peoria, Peoria, IL, USA

    Nguyet Anh Le-Lindqwister

  7. Women & Infants Hospital of Rhode Island, Providence, RI, USA

    William M. Sikov

Authors
  1. Deirdre R. Pachman
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  2. Travis Dockter
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  3. Patricia J. Zekan
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  7. Jacqueline M. Lafky
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  13. Charles L. Loprinzi
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Corresponding author

Correspondence to Charles L. Loprinzi.

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The authors declare that they have no conflict of interest.

Additional information

An abstract, related to the data in this manuscript, was presented and published in 2016.

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Pachman, D.R., Dockter, T., Zekan, P.J. et al. A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I. Support Care Cancer 25, 3407–3416 (2017). https://doi.org/10.1007/s00520-017-3760-2

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  • DOI: https://doi.org/10.1007/s00520-017-3760-2

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