Long-Term Patterns of Chemotherapy-Induced Neuropathy in Women With Breast Cancer
Posted: Monday, April 16, 2018
Treatment with the amino acid acetyl-L carnitine (ACL) seemed to worsen the symptoms of chemotherapy-induced peripheral neuropathy compared with placebo over 2 years, according to the results of the randomized SWOG S0715 trial in women undergoing adjuvant taxane-based chemotherapy for breast cancer. These findings, which were published in the Journal of the National Cancer Institute, may help to inform prevention and treatment strategies for this common and often disabling side effect of taxanes.
The study, led by Dawn L. Hershman, MD, of the Columbia University Medical Center, New York, focused on 409 women randomized to receive 3,000 mg/d of ALC or matching placebo daily for 24 weeks. This treatment was initiated at the start of taxane chemotherapy for breast cancer. Chemotherapy-induced peripheral neuropathy was measured via an 11-item neurotoxicity component of the Functional Assessment of Cancer Therapy–Taxane scale at weeks 12, 24, 36, 52, and 104.
Patients receiving ALC had a statistically significantly greater reduction in neurotoxicity scores (worse chemotherapy-induced peripheral neuropathy) of –1.39 points than the placebo group. The authors noted that these differences were particularly pronounced at weeks 24 (–1.68), 36 (–1.37), and 52 (–1.83).
“We were initially surprised to find that ALC increased [chemotherapy-induced peripheral neuropathy] during the 24-week intervention and continue to be surprised that the difference between arms persisted throughout the 2-year period following ALC discontinuation,” stated Dr. Hershman and colleagues. “The reasons for this are unclear.”
